Individual provider Active NPI

Stefanie Renee Malesevich, FNP

  • Family Nurse Practitioner
  • Grafton, WI
National Provider Identifier
1457969156
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10191 Issued in WI
Practice address
975 Port Washington Rd
Grafton, WI 53024-9201
Phone
(262) 329-1000
NPI assigned
Jul 19, 2020
Last updated
Jan 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10191 WI
Family Nurse Practitioner 363LF0000X 10191 WI Primary

Addresses

Primary practice location

975 Port Washington Rd
Grafton, WI 53024-9201

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (262) 329-1000

Other practice location 1

16650 W Bluemound Rd Ste 200
Brookfield, WI 53005-5959
Phone (262) 827-9200

Other names 1

  • Stefanie Streblow Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL EPIC Health Information Exchange (HIE)
Direct Messaging Address smalesevich328516@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20201106000032 WI Practitioner - Nurse Practitioner 9335559129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

975 Port Washington Rd
Suite 320
Grafton, WI 53024-9201
Phone (262) 329-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10191WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 15, 2020 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Dec 29, 2021 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Dec 29, 2021 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 15, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

16650 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 827-9200

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

975 Port Washington Rd
#320
Grafton, WI 53024
Phone (262) 329-8100

975 Port Washington Rd
Ste 310
Grafton, WI 53024
Phone (262) 329-1000

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1475 W Grand Ave
Port Washington, WI 53074
Phone (262) 268-5100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: smalesevich328516@direct.myadvocateaurora.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.

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": "1595116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1457969156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "262-329-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16650 W Bluemound Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055959",
            "country_code": "US",
            "telephone_number": "262-827-9200",
            "fax_number": "262-827-9858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALESEVICH",
        "first_name": "STEFANIE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-19",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10191",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3200 Pleasant Valley Rd",
            "city": "West Bend",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530959274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smalesevich328516@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "STREBLOW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grafton, WI

Sources for this page

Verify at the official NPI Registry.