Individual provider Active NPI

Andrea F Penister, NP

  • Nurse Practitioner
  • Greenfield, WI
National Provider Identifier
1427374156
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8741-33 Issued in WI
Practice address
6901 W Edgerton Ave
Greenfield, WI 53220-4420
Phone
(414) 325-5244
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 152943-30 WI
Nurse Practitioner 363L00000X 8741-33 WI Primary

Addresses

Primary practice location

6901 W Edgerton Ave
Greenfield, WI 53220-4420

Mailing address

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

Other practice location 1

2801 W Kinnickinnic River Pkwy Ste 250
Milwaukee, WI 53215-3678
Phone (414) 649-7900

Other identifiers 1

IdentifierTypeStateIssuer
100084017MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address apenister28626@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
I20190102000667 WI Practitioner - Nurse Practitioner 5395080998 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

14555 W National Ave
Suite 160
New Berlin, WI 53151-4497
Phone (262) 827-2975

1575 N Rivercenter Dr
Milwaukee, WI 53212-3978
Phone (414) 283-8444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
152943-30WIMDRegistered Nurse
8741-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 22, 2019 Accepting new patients
Vpa PC CurrentSince May 1, 2020 Accepting new patients
Vpa PC Current Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Jan 7, 2019 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jan 4, 2021 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Jan 7, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 22, 2019 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 4, 2021 Accepting new patients
Vpa PC CurrentSince May 1, 2020 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

13555 Bishops Ct
Ste 315
Brookfield, WI 53005
Phone (414) 255-0300

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

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

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

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

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

2801 W Kinnickinnic River Pkwy
Ste 250
Milwaukee, WI 53215
Phone (414) 649-3354

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
Ste 160
New Berlin, WI 53151
Phone (262) 827-2975

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

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

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

Organizations & group practices 12

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": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1427374156",
    "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": "6901 W EDGERTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204420",
            "telephone_number": "414-325-5244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 250",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153678",
            "country_code": "US",
            "telephone_number": "414-649-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENISTER",
        "first_name": "ANDREA",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "152943-30",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8741-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100084017",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apenister28626@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5742 W Roosevelt Dr",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532163156",
            "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": "5742 W Roosevelt Dr",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532163156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.