Individual provider Active NPI

Melissa Koss, APNP

  • Nurse Practitioner
  • Manitowoc, WI
National Provider Identifier
1437527389
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6633 Issued in WI
Practice address
1650 S 41St St
Manitowoc, WI 54220-7316
Phone
(920) 320-3185
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6633 WI Primary

Addresses

Primary practice location

1650 S 41St St
Manitowoc, WI 54220-7316

Mailing address

1650 S 41St St
Manitowoc, WI 54220-7316
Phone (920) 320-3185

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
I20151023001037 WI Practitioner - Nurse Practitioner 2466761952 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians

Practice addresses (Care Compare)

1414 N Taylor Dr
Sheboygan, WI 53081-1988
Phone (920) 320-2436

1650 S 41St St
Manitowoc, WI 54220-7316
Phone (920) 320-2011

3736 S Taylor Dr
Sheboygan, WI 53081-8432
Phone (920) 476-6300

Hospital & facility affiliations

  • Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107
  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6633WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Medical SC CurrentSince Dec 1, 2023 Accepting new patients
Maple Medical SC CurrentSince Dec 1, 2023 Accepting new patients
Froedtert Manitowoc Medical Group, LLC CurrentSince Apr 2, 2022 Accepting new patients

Locations

2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011

1635 S 21st St
Manitowoc, WI 54220
Phone (920) 320-2011

1235 S 24th St
Manitowoc, WI 54220
Phone (920) 320-6620

1650 S 41st St
Manitowoc, WI 54220
Phone (920) 320-3100

2021 S Alverno Rd
Manitowoc, WI 54220
Phone (732) 961-8491

339 Reed Ave
Manitowoc, WI 54220
Phone (920) 320-8600

1414 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 320-2011

800 Lakefront Way
Two Rivers, WI 54241
Phone (920) 320-2011

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

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: mkoss544113@direct.froedtert.com

Organizations & group practices 3

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 2

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1437527389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316",
            "telephone_number": "920-320-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316",
            "telephone_number": "920-320-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSS",
        "first_name": "MELISSA",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.