Individual provider Active NPI

Pauline F Haririe, APNP

  • Primary Care Nurse Practitioner
  • Pewaukee, WI
National Provider Identifier
1508800624
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
86941 Issued in WI
Practice address
N27W23953 Paul Rd Ste 101
Pewaukee, WI 53072-6243
Phone
(262) 646-3223
Fax
(262) 646-3443
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1842 WI
Primary Care Nurse Practitioner 363LP2300X 1842-33 WI
Primary Care Nurse Practitioner 363LP2300X 86941 WI Primary

Addresses

Primary practice location

N27W23953 Paul Rd Ste 101
Pewaukee, WI 53072-6243

Mailing address

N27W23953 Paul Rd Ste 101
Pewaukee, WI 53072-6243
Phone (262) 646-3223

Other identifiers 1

IdentifierTypeStateIssuer
36001800MedicaidWI

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
I20080329000004 WI Practitioner - Nurse Practitioner 9234215393 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

N27W23953 Paul Rd
Suite 101
Pewaukee, WI 53072-6243
Phone (262) 646-3223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1842WIMDNurse Practitioner
1842-33WIMDPrimary Care Nurse Practitioner
86941WIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jun 1, 2020 Accepting new patients
J&P Haririe Midlevel Healthcare Associates CurrentSince Jun 1, 2014 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients
Advanced Lipidology, S.C. PastSince Jun 1, 2014 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

524 Milwaukee St
Ste 180
Delafield, WI 53018
Phone (262) 646-3223

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

N27W23953 Paul Rd
Ste 101
Pewaukee, WI 53072
Phone (262) 646-3223

Organizations & group practices 4

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1508800624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N27W23953 PAUL RD STE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530726243",
            "telephone_number": "262-646-3223",
            "fax_number": "262-646-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N27W23953 PAUL RD STE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530726243",
            "telephone_number": "262-646-3223",
            "fax_number": "262-646-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARIRIE",
        "first_name": "PAULINE",
        "middle_name": "F",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1842",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "1842-33",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "86941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36001800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

Verify at the official NPI Registry.