Individual provider Active NPI

Suzanne L Dupont, APNP

  • Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1457763898
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6359-33 Issued in WI
Practice address
229 S Morrison St
Appleton, WI 54911-5725
Phone
(920) 832-2783
Fax
(920) 832-2797
NPI assigned
May 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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 109248-30 WI
Nurse Practitioner 363L00000X 6359-33 WI Primary

Addresses

Primary practice location

229 S Morrison St
Appleton, WI 54911-5725

Mailing address

229 S Morrison St
Appleton, WI 54911-5725
Phone (920) 832-2783

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
I20150715001692 WI Practitioner - Nurse Practitioner 4587977871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Family Health IncGroup PAC ID 4082925243, 14 clinicians

Practice addresses (Care Compare)

229 S Morrison St
Appleton, WI 54911-5725
Phone (920) 832-2783

Merit-based Incentive Payment System (MIPS)

Final score
92.06 of 100Reported as group
Quality
84.62
Improvement activities
40
Cost
77.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109248-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Family Health, Inc CurrentSince Jul 1, 2015 Accepting new patients

Locations

2915 N Meade St
Appleton, WI 54911
Phone (920) 831-8700

3300 W Brewster St
Appleton, WI 54914
Phone (920) 832-1657

100 N Oneida St
Appleton, WI 54911
Phone (920) 832-2783

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

229 S Morrison St
Appleton, WI 54911
Phone (920) 832-2783

Organizations & group practices 1

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": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1457763898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 S MORRISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115725",
            "telephone_number": "920-832-2783",
            "fax_number": "920-832-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S MORRISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115725",
            "telephone_number": "920-832-2783",
            "fax_number": "920-832-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPONT",
        "first_name": "SUZANNE",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "109248-30",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6359-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.