Individual provider Active NPI

Isis Judith Lozano Vazquez

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1437759115
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
16119 Issued in WI
Practice address
130 W Bruce St
Milwaukee, WI 53204-1667
Phone
(414) 384-1400
Fax
(414) 672-7012
NPI assigned
Oct 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 AP61104176 WA
Nurse Practitioner 363L00000X 16119 WI Primary

Addresses

Primary practice location

130 W Bruce St
Milwaukee, WI 53204-1667

Mailing address

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

Other practice location 1

1112 S Cushman Ave
Tacoma, WA 98405-3631
Phone (253) 593-2144

Other identifiers 1

IdentifierTypeStateIssuer
100295429MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address ilozano109830@direct.aurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211103000476 WA Practitioner - Nurse Practitioner 2062800543 Reassigns benefits to 1 organization
I20241106000985 WI Practitioner - Nurse Practitioner 2062800543 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16119WIMDNurse Practitioner
AP61104176WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 30, 2024 Accepting new patients
Sea Mar Community Health Centers CurrentSince Oct 26, 2021 Accepting new patients
Sea Mar Community Health Centers Nurse Practitioner Current Accepting new patients
Sea Mar Community Health Centers Nurse Practitioner CurrentSince Oct 26, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 30, 2024 Accepting new patients
Aurora Medical Group, Inc. PastSince Dec 1, 2024 Accepting new patients

Locations

1112 S Cushman Ave
Tacoma, WA 98405
Phone (253) 593-2144

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

130 W Bruce St
Ste 300
Milwaukee, WI 53204
Phone (414) 384-1400

Organizations & group practices 6

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": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1437759115",
    "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": "130 W BRUCE ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532041667",
            "telephone_number": "414-384-1400",
            "fax_number": "414-672-7012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 S Cushman Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984053631",
            "country_code": "US",
            "telephone_number": "253-593-2144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOZANO VAZQUEZ",
        "first_name": "ISIS",
        "middle_name": "JUDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61104176",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "16119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100295429",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "130 W Bruce St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532041667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ilozano109830@direct.aurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "130 W Bruce St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532041667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.