Individual provider Active NPI

Ellen A Radocay, APNP

  • Family Nurse Practitioner
  • Luxemburg, WI
National Provider Identifier
1538575048
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5967-33 Issued in WI
Practice address
140B School Creek TRL
Luxemburg, WI 54217-1095
Phone
(920) 845-1370
Fax
(920) 845-1379
NPI assigned
Jul 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 174211-30 WI
Family Nurse Practitioner 363LF0000X 5967-33 WI Primary

Addresses

Primary practice location

140B School Creek TRL
Luxemburg, WI 54217-1095

Mailing address

PO Box 22487
Green Bay
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other practice location 1

723 S Wisconsin St
Pulaski, WI 54162-9303
Phone (920) 822-1100

Other practice location 2

405 Commercial St
Seymour, WI 54165-8474
Phone (920) 833-2318

Other practice location 3

831 Parker St
Algoma
Algoma, WI 54201
Phone (920) 487-3676

Other identifiers 2

IdentifierTypeStateIssuer
13673570OtherCAQH
F0814117OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS

Other names 1

  • Ellen A Torzewski,Bonzell Former name

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
I20141014000383 WI Practitioner - Nurse Practitioner 6709006885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

831 Parker Ave
Algoma, WI 54201-1808
Phone (920) 433-3640

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
174211-30WIMDRegistered Nurse
5967-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Oct 13, 2014 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Oct 13, 2014 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

1510 Fremont St
Algoma, WI 54201
Phone (920) 487-3676

831 Parker Ave
Algoma, WI 54201
Phone (920) 487-3084

2550 S Ashland Ave
Green Bay, WI 54304
Phone (920) 548-7337

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

575 4th St
Kewaunee, WI 54216
Phone (920) 388-4640

140 School Creek Trl
#B
Luxemburg, WI 54217
Phone (920) 845-1370

723 S Wisconsin St
Pulaski, WI 54162
Phone (920) 822-1100

405 Commercial St
Seymour, WI 54165
Phone (920) 833-2318

555 Quality Ct
Wrightstown, WI 54180
Phone (920) 532-0700

Interoperability endpoints

  • Direct secure messaging: eradocay925490@direct.emplifyhealth.org
  • Direct secure messaging: ebonzell42853@direct.thedacare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1538575048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "address_2": "GREEN BAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140B SCHOOL CREEK TRL",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542171095",
            "telephone_number": "920-845-1370",
            "fax_number": "920-845-1379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "723 S Wisconsin St",
            "address_purpose": "LOCATION",
            "city": "Pulaski",
            "state": "WI",
            "postal_code": "541629303",
            "country_code": "US",
            "telephone_number": "920-822-1100",
            "fax_number": "920-822-5731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Commercial St",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "WI",
            "postal_code": "541658474",
            "country_code": "US",
            "telephone_number": "920-833-2318",
            "fax_number": "920-833-6883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "831 Parker St",
            "address_2": "Algoma",
            "address_purpose": "LOCATION",
            "city": "Algoma",
            "state": "WI",
            "postal_code": "54201",
            "country_code": "US",
            "telephone_number": "920-487-3676",
            "fax_number": "920-487-3084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADOCAY",
        "first_name": "ELLEN",
        "middle_name": "A",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "174211-30",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5967-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13673570",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F0814117",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "TORZEWSKI,BONZELL",
            "middle_name": "A",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Luxemburg, WI

Sources for this page

Verify at the official NPI Registry.