Individual provider Active NPI

Angeline Vercauteren

  • Psychiatric/Mental Health Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1407287543
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5584-33 Issued in WI
Practice address
2020 W Wells St
Milwaukee, WI 53233-2720
Phone
(414) 476-9675
NPI assigned
Nov 27, 2013
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5584-33 WI Primary

Addresses

Primary practice location

2020 W Wells St
Milwaukee, WI 53233-2720

Mailing address

2020 W Wells St
Milwaukee, WI 53233-2720
Phone (414) 241-9670

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140219001793 WI Practitioner - Nurse Practitioner 6305076290 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5584-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Center for Independence Inc Single Specialty Current Accepting new patients
Milwaukee Center for Independence Inc Single Specialty CurrentSince Feb 2, 2023 Accepting new patients

Locations

2020 W Wells St
Milwaukee, WI 53233
Phone (414) 476-9675

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1407287543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W WELLS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332720",
            "telephone_number": "414-241-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W WELLS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332720",
            "telephone_number": "414-476-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERCAUTEREN",
        "first_name": "ANGELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-27",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "5584-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.