Individual provider Active NPI

Sophia N Gumina

  • Psychiatric/Mental Health Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1568324325
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
17601-33 Issued in WI
Practice address
309 E North St
Waukesha, WI 53188-3718
Phone
(262) 408-2530
NPI assigned
Dec 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 17601-33 WI Primary

Addresses

Primary practice location

309 E North St
Waukesha, WI 53188-3718

Mailing address

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Phone (414) 672-1353

Other practice location 1

4570 S 27th St
Milwaukee, WI 53221-2145
Phone (414) 672-1353

Other practice location 2

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Phone (414) 672-1353

Other practice location 3

1635 W National Ave
Milwaukee, WI 53204-1130
Phone (414) 672-1353

Other practice location 4

2906 S 20th St
Milwaukee, WI 53215-3732
Phone (414) 672-1353

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
I20260602002481 WI Practitioner - Nurse Practitioner 1456822311

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17601-33WIMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1568324325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "telephone_number": "414-672-1353",
            "fax_number": "262-408-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E NORTH ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883718",
            "telephone_number": "262-408-2530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4570 S 27th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532212145",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "fax_number": "262-408-5094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1032 S Cesar E Chavez Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532042203",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "fax_number": "262-408-5094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1635 W National Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532041130",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "fax_number": "262-408-5094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2906 S 20th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153732",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "fax_number": "262-408-5094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUMINA",
        "first_name": "SOPHIA",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "17601-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.