Individual provider Active NPI

Suzanne Girard, NP

  • Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1578196770
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9869-30 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 948-7030
NPI assigned
Feb 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9869-30 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

2600 N Mayfair Rd Ste 545
Wauwatosa, WI 53226-1306
Phone (414) 476-0430

Other identifiers 1

IdentifierTypeStateIssuer
100097904MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address sgirard311812@direct.myadvocateaurora.org Direct

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
I20200317000461 WI Practitioner - Nurse Practitioner 6608204110 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

4536 22ND Ave
Kenosha, WI 53140-5917
Phone (262) 656-0044

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9869-30WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kenosha Community Health Center, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 2, 2023 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Dec 2, 2023 Accepting new patients
Kenosha Community Health Center, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince Dec 2, 2023 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Nurse Practitioner CurrentSince Mar 4, 2020 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Dec 2, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 2, 2023 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Dec 2, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Kenosha Community Health Center, Inc Past Accepting new patients
Kenosha Community Health Center, Inc Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

6226 14th Ave
Kenosha, WI 53143
Phone (262) 656-0044

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

4536 22nd Ave
Kenosha, WI 53140
Phone (262) 656-0044

4006 Washington Rd
Kenosha, WI 53144
Phone (262) 652-4006

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

8400 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 231-3000

3811 Spring St
Ste 302
Mount Pleasant, WI 53405
Phone (262) 687-8202

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2621 S Green Bay Rd
Racine, WI 53406
Phone (262) 504-6100

903 S 2nd St
Silver Lake, WI 53170
Phone (262) 656-0044

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: sgirard594845@direct.ochin.org
  • Direct secure messaging: sgirard311812@direct.myadvocateaurora.org

Organizations & group practices 12

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 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": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1578196770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 N Mayfair Rd Ste 545",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532261306",
            "country_code": "US",
            "telephone_number": "414-476-0430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIRARD",
        "first_name": "SUZANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-15",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9869-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097904",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgirard311812@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.