Individual provider Active NPI

Taylor Lynn Lidwin

  • Family Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1427869593
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16240-33 Issued in WI
Practice address
N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone
(262) 875-4521
NPI assigned
Jan 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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 16240-33 WI Primary

Addresses

Primary practice location

N20W22961 Watertown Rd
Waukesha, WI 53186-1306

Mailing address

N20W22961 Watertown Rd
Waukesha, WI 53186-1306

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
I20250227003170 WI Practitioner - Nurse Practitioner 9830619246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oak Medical SCGroup PAC ID 0042595175, 118 clinicians
Maple Medical SCGroup PAC ID 9032471248, 25 clinicians

Practice addresses (Care Compare)

2195 N Summit Village Way
Oconomowoc, WI 53066-8675
Phone (262) 567-4662

N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone (262) 875-5070

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16240-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Medical SC CurrentSince Feb 1, 2025 Accepting new patients
Oak Medical SC CurrentSince Feb 1, 2025 Accepting new patients

Locations

2195 N Summit Village Way
Summit, WI 53066
Phone (262) 560-2400

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1427869593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306",
            "telephone_number": "262-875-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDWIN",
        "first_name": "TAYLOR",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "16240-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.