Individual provider Active NPI

Elizabeth Demeyer, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1659810430
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7535-33 Issued in WI
Practice address
2224 W Kilbourn Ave
Milwaukee, WI 53233-1614
Phone
(414) 931-6670
NPI assigned
Feb 14, 2017
Last updated
Mar 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7535-33 WI Primary

Addresses

Primary practice location

2224 W Kilbourn Ave
Milwaukee, WI 53233-1614

Mailing address

2224 W Kilbourn Ave
Milwaukee, WI 53233-1614
Phone (414) 339-4135

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
I20181031000388 WI Practitioner - Nurse Practitioner 0547513038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1500 Walnut Ridge Dr
Hartland, WI 53029-9317
Phone (262) 928-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7535-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Oct 19, 2018 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

1500 Walnut Ridge Dr
Hartland, WI 53029
Phone (262) 513-7500

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1659810430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 W KILBOURN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331614",
            "telephone_number": "414-339-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 W KILBOURN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331614",
            "telephone_number": "414-931-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMEYER",
        "first_name": "ELIZABETH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7535-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.