Eric Monticello, APRN,CNP

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

8099 Issued in WI

Practice address

1300 South Drive
Winnebago, WI 54985-5498

Phone

(920) 235-4910

NPI assigned

Aug 22, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, WI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, 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.

• Waukesha County

  • Case Management Agency
  • Waukesha, WI
  • NPI 1740403146
  Medicare reassignment NPD
• PSJ Acquisition LLC

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1679709802

  Psychiatry

  Medicare reassignment NPD
• Waukesha County

  • Mental Illness Community Based Residential Treatment Facility
  • Waukesha, WI
  • NPI 1477314854
  NPD
• Waukesha County

  • Psychiatry Physician
  • Waukesha, WI
  • NPI 1629292651
  NPD
• PSJ Acquisition LLC

  • Psychologist
  • Fargo, ND
  • NPI 1720454267
  NPD
• Winnebago Mental Health Institute

  • Psychiatric Hospital
  • Winnebago, WI
  • NPI 1164516506
  NPD (past)

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1558816306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SOUTH DRIVE",
            "city": "WINNEBAGO",
            "state": "WI",
            "postal_code": "549855498",
            "telephone_number": "920-235-4910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1702 University Dr S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581034940",
            "country_code": "US",
            "telephone_number": "701-364-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 Douglas St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277056616",
            "country_code": "US",
            "telephone_number": "919-908-9730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTICELLO",
        "first_name": "ERIC",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-22",
        "last_updated": "2023-07-18",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "R38492",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "295229",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R38492",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "8099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony M Lichtfuss, LCSW
• Alla Y Likhterev, M.D.
• Donald Ervin Linneman, D.D.S.
• Thomas Michlowski
• Konstantin A Mikheyev, DO
• C Harold Mork, M.D.
• Jenna Nelson, PSY.D.
• Jeri A Nelson, M.D.
• Jeremiah Lee Olson, CSAC, ICS
• Kevin Paul Pittenger, APNP

• Psychiatry Physician in Winnebago, WI
• Providers in Winnebago, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.