Kirsten Sarah Collins, NP
Individual provider Active NPI Family Nurse Practitioner · Mukwonago, WI
NPI 1417501065 · NPPES record last updated Oct 24, 2019
Key facts
- NPI
- 1417501065
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 9157-33 (WI)
- Practice address
- 240 Maple Ave
Mukwonago, WI 53149-8475 - Phone
- (262) 363-1900
- NPI assigned
- Jul 31, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prohealth Medical Group Inc
Practice addresses (Care Compare)
240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900
Hospital & facility affiliations
- Waukesha Memorial Hospital
- Oconomowoc Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191022001308 | WI | Practitioner - Nurse Practitioner | 7214269497 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9157-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc. | Current |
Accepting new patients | |
| Prohealth Medical Group Inc | Current |
Accepting new patients | |
| Prohealth Medical Group Inc | Past | Accepting new patients |
Locations
240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900
N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9157-33 | WI | Yes |
Addresses
Primary practice location
240 Maple Ave
Mukwonago, WI 53149-8475
Mailing address
240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 363-1900
Other providers in Mukwonago, WI
- Chiropractic Firsts.C.
- Crysta Clark
- Sarah Cleaver
- Stephanie L Coates-McFeeley
- Katherine Diane Collins
- Michael F Connor
- Jennifer Jean Cook
- Jean Cottrell
- Kathryn Craig
- Crossroad Therapy, LLC
All providers in Mukwonago, WI · Family Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.