Individual provider Active NPI

Susan A Sanfilippo, NP

  • Nurse Practitioner
  • Marinette, WI
National Provider Identifier
1457591869
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3662-33 Issued in WI
Practice address
3200 Shore Dr
Marinette, WI 54143-4292
Phone
(715) 732-8610
NPI assigned
Feb 25, 2009
Last updated
Dec 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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 3662-33 WI Primary

Addresses

Primary practice location

3200 Shore Dr
Marinette, WI 54143-4292

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (715) 732-8610

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
I20090401000202 WI Practitioner - Nurse Practitioner 0840357117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, shared by 12 NPIs, 217 clinicians

Practice addresses (Care Compare)

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3662-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Apr 1, 2009 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Nov 1, 2016 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Nov 1, 2016 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Apr 1, 2009 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients

Locations

106 S School Rd
Daggett, MI 49821
Phone (906) 753-2155

1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

3200 Shore Dr
Marinette, WI 54143
Phone (715) 732-8610

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

607 E Bronson Rd
Seymour, WI 54165
Phone (920) 833-6856

Interoperability endpoints

  • Direct secure messaging: ssanfilippo926359@direct.emplifyhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1457591869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "715-732-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SHORE DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434292",
            "telephone_number": "715-732-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFILIPPO",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3662-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.