Individual provider Active NPI

Meredith L Drvaric, DNP-FNP, FNP-BC, RN

  • Nurse Practitioner
  • Mequon, WI
National Provider Identifier
1417425349
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8869-33 Issued in WI
Practice address
6425 W Mequon Rd
Mequon, WI 53092-1862
Phone
(262) 387-8200
NPI assigned
Nov 8, 2018
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8869-33 WI
Nurse Practitioner 363L00000X 8869-33 WI Primary

Addresses

Primary practice location

6425 W Mequon Rd
Mequon, WI 53092-1862

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1650 N Farwell Ave
Milwaukee, WI 53202-2331
Phone (414) 277-5054

Other practice location 2

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-9400

Other identifiers 2

IdentifierTypeStateIssuer
100083163MedicaidWI
1417425349MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mdrvaric12777@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20181228000549 WI Practitioner - Nurse Practitioner 7719222405 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8869-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jun 1, 2024 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Nov 14, 2018 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jun 1, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

16985 W Bluemound Rd
Brookfield, WI 53005
Phone (262) 641-8400

9200 W Loomis Rd
Franklin, WI 53132
Phone (414) 529-9200

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

215 Washington St
Grafton, WI 53024
Phone (262) 375-3700

6425 W Mequon Rd
Mequon, WI 53092
Phone (262) 242-0051

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

3289 N Mayfair Rd
Wauwatosa, WI 53222
Phone (414) 771-7900

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

6609 W Greenfield Ave
West Allis, WI 53214
Phone (414) 257-8500

Organizations & group practices 8

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": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1417425349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921862",
            "telephone_number": "262-387-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 N Farwell Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532022331",
            "country_code": "US",
            "telephone_number": "414-277-5054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-9400",
            "fax_number": "414-456-6211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRVARIC",
        "first_name": "MEREDITH",
        "middle_name": "L",
        "credential": "DNP-FNP, FNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8869-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8869-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100083163",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417425349",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdrvaric12777@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6425 W Mequon Rd",
            "city": "Mequon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530921862",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6425 W Mequon Rd",
            "city": "Mequon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530921862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.