Mary K. Yellick, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1417 Issued in WI

Practice address

285 Forest Grove Dr
Ste 124
Pewaukee, WI 53072-3716

Phone

(262) 329-8100

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
• Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440
  Medicare reassignment Care Compare group NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Hartland, WI
  • NPI 1386785178
  NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  NPD (past)

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

• Prohealth Oconomowoc Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Oconomowoc, WI
  • NPI 1366420531
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  • Community/Retail Pharmacy
  • Oconomowoc, WI
  • NPI 1497942205

  Hospital

  Care Compare affiliation
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1508812918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 FOREST GROVE DR",
            "address_2": "STE 124",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723716",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 FOREST GROVE DR",
            "address_2": "STE 124",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723716",
            "telephone_number": "262-329-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLICK",
        "first_name": "MARY",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1417",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "1417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508812918",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36009400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori L Wisnefski, M.D.
• Leigh Ann Wood
• Dannielle Patricia Wunderlich, DPT
• Sarah Wutke
• Leng Xiong, DPM
• Cassandra Young, PT
• McKenna Rae Young, OD
• Bailey Youngblade, DDS
• Andrea Zabel, DNP
• Alexander Daniel Zacharias

• Family Nurse Practitioner in Pewaukee, WI
• Providers in Pewaukee, 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 Jun 7, 2023; 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.