Tracy M Peterson, NURSE PRACTIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2967-033 Issued in WI

Practice address

3077 N Mayfair Rd Ste 305
Wauwatosa, WI 53222-4305

Phone

(414) 384-6700

Fax

(414) 384-3008

NPI assigned

Oct 17, 2006

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 2

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Surgeons of Wisconsin SCGroup PAC ID 5294727152, 61 clinicians

Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Midwest Orthopedic Specialty Hospital, LLCGroup PAC ID 7113078833, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
• Midwest Orthopedic Specialty Hospital Hospital, Franklin, WI, CCN 520205

Merit-based Incentive Payment System (MIPS)

Final score

81.61 of 100Reported as group

Quality

73.65

Promoting interoperability

87

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.peterson.1@32957.direct.athenahealth.com

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.

• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Midwest Orthopedic Specialty Hospital, LLC

  • Orthopaedic Surgery Physician
  • Franklin, WI
  • NPI 1275127375
  Medicare reassignment Care Compare group NPD
• Orthopedic Surgeons of Wisconsin, S.C.

  • Orthopaedic Surgery Physician
  • Wauwatosa, WI
  • NPI 1295769321

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Midwest Orthopedic Specialty Hospital, LLC

  • Rehabilitation Clinic/Center
  • Oak Creek, WI
  • NPI 1811635949
  NPD
• Midwest Orthopedic Specialty Hospital, LLC

  • Durable Medical Equipment & Medical Supplies
  • Muskego, WI
  • NPI 1962238113
  NPD
• Ascension All Saints Hospital, Inc

  • Rehabilitation Hospital Unit
  • Racine, WI
  • NPI 1417966540
  NPD (past)
• Wheaton Franciscan Medical Group

  • Urology Physician
  • Brookfield, WI
  • NPI 1639250210
  NPD (past)

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

• Ascension All Saints Hospital, Inc

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284
  Care Compare affiliation
• Midwest Orthopedic Specialty Hospital, LLC

  • Special Hospital
  • Franklin, WI
  • NPI 1861635971
  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1619058740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY",
            "address_2": "SUITE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153677",
            "telephone_number": "414-384-6700",
            "fax_number": "414-384-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 N MAYFAIR RD STE 305",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224305",
            "telephone_number": "414-384-6700",
            "fax_number": "414-384-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TRACY",
        "middle_name": "M",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2967-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36011500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4126880",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy K Petersdorf, MA
• Talya Marie Petersik, M.S.
• Peterson Lactation Services
• Kimberly Anne Peterson, M.A. CCC-SLP
• Molly G Peterson, BS, IBCLC, RLC
• Janelle Marie Petinga, ANP-BC
• Katelin Petrin, CPNP
• Jacquelyn P Petropoulos, PTA
• Michael Anthony Pezewski, PHARMD
• Margaret Pfeiffer, M.S., R.D., C.L.S.

• Nurse Practitioner in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.