Tracy Derksen, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9480-33 Issued in WI

Practice address

1701 Fond Du Lac Ave
Kewaskum, WI 53040-9129

Phone

(262) 626-4616

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Preceptor Home Health Home health agency, Germantown, WI, CCN 527313
• St Josephs Community Hospital West Bend Hospital, West Bend, WI, CCN 520063

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tderksen129493@direct.froedtert.com

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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Fox Valley Pulmonary Medicine, S.C.

  • Pulmonary Disease Physician
  • Appleton, WI
  • NPI 1366506016

  Single Specialty

  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224

  Single Specialty

  NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Single Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Great Lakes Healthcare, Inc.

  • Home Health Agency
  • Germantown, WI
  • NPI 1255996740
  Care Compare affiliation
• St. Josephs Community Hospital of West Bend Inc.

  • General Acute Care Hospital
  • West Bend, WI
  • NPI 1851336044
  Care Compare affiliation

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1497304612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 FOND DU LAC AVE",
            "city": "KEWASKUM",
            "state": "WI",
            "postal_code": "530409129",
            "telephone_number": "262-626-4616",
            "fax_number": "262-626-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 FOND DU LAC AVE",
            "city": "KEWASKUM",
            "state": "WI",
            "postal_code": "530409129",
            "telephone_number": "262-626-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKSEN",
        "first_name": "TRACY",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9480-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Budny, MD
• Robert Allen Butler, D.C.
• Alysha Claflin, DPT
• Cheryl Elizabeth Colwin, LPC, CSAC, ICS
• J Dennis Connor, DDS
• Steven Erdmann, EDS
• Exodus Transitional Care Facility Inc.
• Nicolai S Gerhartz, PA-C
• Suzanne Marie Gessner, RN
• Mateusz Gwizdala, MD

• Family Nurse Practitioner in Kewaskum, WI
• Providers in Kewaskum, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.