Individual provider Active NPI

Rosaoleana Aguilar Audeo

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1417301565
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6695-33 Issued in WI
Practice address
209 W Orchard St
Milwaukee, WI 53204-2957
Phone
(414) 647-7466
Fax
(414) 527-7630
NPI assigned
Apr 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6695-33 WI Primary

Addresses

Primary practice location

209 W Orchard St
Milwaukee, WI 53204-2957

Mailing address

209 W Orchard St
Milwaukee, WI 53204-2957
Phone (414) 647-7466

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
I20160707002158 WI Practitioner - Nurse Practitioner 1557653706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1320 Wisconsin Ave
Racine, WI 53403-1978
Phone (262) 687-2364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6695-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jun 22, 2016 Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

1320 Wisconsin Ave
Racine, WI 53403
Phone (262) 687-2222

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1417301565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W ORCHARD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042957",
            "telephone_number": "414-647-7466",
            "fax_number": "414-527-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W ORCHARD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042957",
            "telephone_number": "414-647-7466",
            "fax_number": "414-527-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR AUDEO",
        "first_name": "ROSAOLEANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6695-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.