Kaitlin Rose Grigoryev

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13152 Issued in WI

Practice address

N112W15415 Mequon Rd
Germantown, WI 53022-3410

Phone

(262) 250-7800

NPI assigned

Jul 14, 2022

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

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

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

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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
• Columbia St. Mary'S Hospital Milwaukee, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482
  Medicare reassignment NPD
• Columbia St. Mary'S Hospital Milwaukee Inc

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD
• Ascension All Saints Hospital, Inc

  • Rehabilitation Hospital Unit
  • Racine, WI
  • NPI 1417966540
  NPD (past)

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

• Ascension SE Wisconsin Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Columbia St. Mary'S Hospital Milwaukee, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1871656082
  Care Compare affiliation

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1619601770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W RIVER WOODS PKWY",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N112W15415 MEQUON RD",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223410",
            "telephone_number": "262-250-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGORYEV",
        "first_name": "KAITLIN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "13152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Gottsacker, P.T., C.PED.
• Great Lakes Dental, LLC
• Great Lakes Healthcare, Inc.
• Great Lakes Healthcare, Inc.
• Great Lakes Healthcare, Inc.
• Marisa Groshek, DPT
• Erin Therese Grueneberg, DNP
• Carissa Anne Guagliardo
• Katherine Habanek, DC
• Sabrina R Hafeman, OTR

• Family Nurse Practitioner in Germantown, WI
• Providers in Germantown, 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 Feb 15, 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.