Individual provider Active NPI

Rebecca Maria Mecozzi, APNP

  • Family Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1558029967
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11574 Issued in WI
Practice address
N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone
(262) 696-0909
NPI assigned
Dec 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11574-33 WI
Family Nurse Practitioner 363LF0000X 11574 WI Primary

Addresses

Primary practice location

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106

Mailing address

N75W25241 Beverly LN
Sussex, WI 53089-1109
Phone (847) 271-2883

Other practice location 1

10400 75th St
Kenosha, WI 53142-7884
Phone (262) 948-7260

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
I20220713003853 WI Practitioner - Nurse Practitioner 0446631063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11574WIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc CurrentSince Jul 1, 2022 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Jul 1, 2022 Accepting new patients

Locations

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

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.

Hospital & facility affiliations 3

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": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1558029967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N75W25241 BEVERLY LN",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530891109",
            "telephone_number": "847-271-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N16W24131 RIVERWOOD DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881106",
            "telephone_number": "262-696-0909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 75th St",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427884",
            "country_code": "US",
            "telephone_number": "262-948-7260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MECOZZI",
        "first_name": "REBECCA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11574-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.