Beth A Hultman, NNP
Individual provider Active NPI Nurse Practitioner · Summit, WI
NPI 1497208409 · NPPES record last updated Jul 29, 2025
Key facts
- NPI
- 1497208409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 7069 (WI)
- Practice address
- 36500 Aurora Dr
Summit, WI 53066-4899 - Phone
- (262) 434-5000
- NPI assigned
- Jul 26, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160815001384 | WI | Practitioner - Nurse Practitioner | 5496049488 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7069 | WI | MD | Nurse Practitioner |
| 7069-33 | WI | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Current |
Accepting new patients | |
| Prohealth Medical Group Inc | Past | Accepting new patients |
Locations
240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900
725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 7069 | WI | Yes |
Addresses
Primary practice location
36500 Aurora Dr
Summit, WI 53066-4899
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100058821 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bhultman51646@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Summit, WI
- Charles R Hollman
- Hailee I. Holt
- Angela M Holtzman
- Emily G Holzwart
- Megan R Hoyer
- Steven J Hunter
- Abbey Hurtis
- Rachel Hyland
- Ahmed Mohsin Ibn-Mahfoudh
- Kimberly Couture Ireland
All providers in Summit, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.