Joline Brotzman, MS, RN, PMHCNS-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5048-33 Issued in WI

Practice address

459 E 1St St
Fond Du Lac, WI 54935-4505

Phone

(920) 922-3324

Fax

(920) 929-3129

NPI assigned

Sep 17, 2012

Last updated

May 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Joline Michelle Levanetz Former name

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fond Du Lac CountyGroup PAC ID 2668376245, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jbrotzman207058@direct.myadvocateaurora.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fond Du Lac County

  dba Department of Human Services Clinical Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fond Du Lac, WI
  • NPI 1053458935
  Medicare reassignment Care Compare group
• Serenity Psychiatry, LLC

  • Community/Behavioral Health Agency
  • Fond Du Lac, WI
  • NPI 1952159899
  NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1578813606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354357",
            "telephone_number": "920-315-3922",
            "fax_number": "920-214-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354505",
            "telephone_number": "920-922-3324",
            "fax_number": "920-929-3129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "298 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354357",
            "country_code": "US",
            "telephone_number": "920-315-3922",
            "fax_number": "920-214-1076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROTZMAN",
        "first_name": "JOLINE",
        "credential": "MS, RN, PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5048-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "5048-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100026161",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100084008",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOLINE",
            "last_name": "LEVANETZ",
            "middle_name": "MICHELLE",
            "credential": "MS, PMHNP-BC, APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brooke N Brock
• Brookdale Senior Living Communities, Inc. (Sterling House of Fond du Lac)
• Brooke Industries, Inc.
• Molly Marie Brooks, COTA
• Eddie Kiyoshi Brotkowski, D.D.S., M.D.
• Lisa Diane Brown, LCSW
• Lisette C Brown, PA C
• Pamela G Brown, OD
• Pierce Brown
• Rachel A Brown

• Psychiatric/Mental Health Nurse Practitioner in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.