Individual provider Active NPI

Tiffany Anne Zamzow, NNP-BC, APNP

  • Nurse Practitioner
  • Grafton, WI
National Provider Identifier
1588906150
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5255-033 Issued in WI
Practice address
975 Port Washington Rd
Grafton, WI 53024-9201
Phone
(262) 329-4900
Fax
(262) 329-4901
NPI assigned
Mar 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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 5255-033 WI Primary
Neonatal Nurse Practitioner 363LN0000X 5255-33 WI

Addresses

Primary practice location

975 Port Washington Rd
Grafton, WI 53024-9201

Mailing address

975 Port Washington Rd
Grafton, WI 53024-9201
Phone (262) 329-4900

Other identifiers 1

IdentifierTypeStateIssuer
1588906150MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address tzamzow181624@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
I20131001000424 WI Practitioner - Nurse Practitioner 0840424057 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5255-033WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Apr 6, 2024 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Apr 6, 2024 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Apr 6, 2024 Accepting new patients

Locations

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

975 Port Washington Rd
#320
Grafton, WI 53024
Phone (262) 329-8100

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

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

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

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1588906150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-4900",
            "fax_number": "262-329-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-4900",
            "fax_number": "262-329-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMZOW",
        "first_name": "TIFFANY",
        "middle_name": "ANNE",
        "credential": "NNP-BC, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5255-033",
            "primary": true
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WI",
            "license": "5255-33",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588906150",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tzamzow181624@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

Verify at the official NPI Registry.