Elyse Marie Engebose, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6533-33 Issued in WI

Practice address

140B School Creek TRL
Luxemburg, WI 54217-1095

Phone

(920) 845-1370

Fax

(920) 845-1379

NPI assigned

Aug 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Hospital-Hospital Sisters-Third Order of St FrancisGroup PAC ID 5799694675, 593 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent Hospital Hospital, Green Bay, WI, CCN 520075

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eengebose42876@direct.thedacare.org
• Direct secure messaging: eengebose214931@ewd.direct.hshs.org

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.

• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health

  • General Practice Physician
  • Green Bay, WI
  • NPI 1285613638
  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health Algoma

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment NPD
• Prevea Clinic, Inc.

  • Internal Medicine Physician
  • Green Bay, WI
  • NPI 1306869276
  Medicare reassignment NPD
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  dba Prevea Sheboygan Health Center

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1275799413
  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health Fast Care East

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1346293941
  NPD
• Prevea Clinic, Inc.

  • Family Medicine Physician
  • Chippewa Falls, WI
  • NPI 1588110969
  NPD
• St Nicholas Hospital-Sisters of the Third Order of St Francis

  dba St Nicholas Hospital Professional Services Group

  • Nurse Practitioner
  • Sheboygan, WI
  • NPI 1275943243

  Family

  NPD
• St Nicholas Hospital-Sisters of the Third Order of St Francis

  dba St. Nicholas Hospital

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1447737762
  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health

  • Durable Medical Equipment & Medical Supplies
  • Green Bay, WI
  • NPI 1245042530
  NPD

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

• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba St Vincent Hospital

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1114908001
  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Sheboygan, WI
  • NPI 1831784636

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  dba St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Green Bay, WI
  • NPI 1184004236

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  dba St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Oconto Falls, WI
  • NPI 1750760740

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  dba St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Sturgeon Bay, WI
  • NPI 1760861751

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1609252139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140B SCHOOL CREEK TRL",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542171095",
            "telephone_number": "920-845-1370",
            "fax_number": "920-845-1379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135753",
            "country_code": "US",
            "telephone_number": "920-430-4560",
            "fax_number": "920-430-4558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "311 N 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Sturgeon Bay",
            "state": "WI",
            "postal_code": "54235",
            "country_code": "US",
            "telephone_number": "920-743-0255",
            "fax_number": "920-743-6680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2714 Riverview Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543136715",
            "country_code": "US",
            "telephone_number": "920-430-4760",
            "fax_number": "920-430-4774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENGEBOSE",
        "first_name": "ELYSE",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6533-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F07151158",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eengebose214931@ewd.direct.hshs.org",
            "affiliation": "Y",
            "affiliationName": "St Vincent Hospital-Hospital Sisters-Third Order of St Francis",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2502 S Ashland Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543045252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Nurse Practitioner in Luxemburg, WI
• Providers in Luxemburg, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.
• 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.