Mary L Theisen, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8349-33 Issued in WI

Practice address

11002 W Park PL
Milwaukee, WI 53224-3615

Phone

(414) 365-8300

NPI assigned

Mar 14, 2018

Last updated

Mar 18, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Horizon Home Care & Hospice, Inc.

  • Home Health Agency
  • Milwaukee, WI
  • NPI 1780687327
  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  NPD
• Molina Care Connections, LLC.

  dba Molina CC

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223
  NPD
• Dr. Steven M Waldman S.C.

  • Podiatrist
  • Wauwatosa, WI
  • NPI 1376626267
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1396248407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11002 W PARK PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243615",
            "telephone_number": "414-365-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11002 W PARK PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243615",
            "telephone_number": "414-365-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 E Drexel Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531542123",
            "country_code": "US",
            "telephone_number": "414-365-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3232 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530959274",
            "country_code": "US",
            "telephone_number": "414-365-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8503 75th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427620",
            "country_code": "US",
            "telephone_number": "414-365-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Lone Oak Ln",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "WI",
            "postal_code": "530272600",
            "country_code": "US",
            "telephone_number": "414-365-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13111 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530972416",
            "country_code": "US",
            "telephone_number": "414-365-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEISEN",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8349-33",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8349-33",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "185282-30",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396248407",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa L Theesfeld, PHARMD
• Thomas Gerald Thein, CSA
• Gerald Allan Theis, M.S.W.
• Janice Mary Theis, NURSE PRACTITIONER
• Maria L Theisen, PA
• Thekey of Wisconsin, LLC
• Leslie Elizabeth Thelan, MD
• Anne Thelen
• Robert Joseph Themmes, APSW
• Mala Thenappan, MD

• Family Nurse Practitioner in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.