Individual provider Active NPI

Sandra Ann Musquiz, RN

  • Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1548513484
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
178265-30 Issued in WI
Practice address
4929 W Fond Du Lac Ave
Milwaukee, WI 53216-2324
Phone
(414) 871-6122
Fax
(414) 871-2552
NPI assigned
Oct 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 178265-30 WI Primary

Addresses

Primary practice location

4929 W Fond Du Lac Ave
Milwaukee, WI 53216-2324

Mailing address

4929 W Fond Du Lac Ave
Milwaukee, WI 53216-2324
Phone (414) 871-6122

Other identifiers 1

IdentifierTypeStateIssuer
178265-30OtherWIRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
178265-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Broadstep-Wisconsin, Inc. Past Accepting new patients
Bell Therapy Family Care Cmu Past Accepting new patients

Organizations & group practices 2

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": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1548513484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162324",
            "telephone_number": "414-871-6122",
            "fax_number": "414-871-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162324",
            "telephone_number": "414-871-6122",
            "fax_number": "414-871-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSQUIZ",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "178265-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "178265-30",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.