Individual provider Active NPI

Cadie Leigh Roszak

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1659936169
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9205 Issued in WI
Practice address
2350 N Lake Dr
Milwaukee, WI 53211-4528
Phone
(414) 271-1622
NPI assigned
May 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 9205 WI Primary

Addresses

Primary practice location

2350 N Lake Dr
Milwaukee, WI 53211-4528

Mailing address

1011 E Elm Rd
Oak Creek, WI 53154-6478
Phone (414) 313-8561

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
I20190718000438 WI Practitioner - Nurse Practitioner 9133454754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Jul 10, 2019 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Single Specialty CurrentSince Jul 10, 2019 Accepting new patients
Marciana Group Single Specialty Past Accepting new patients

Locations

2350 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1556

2350 N Lake Dr
Ste 400
Milwaukee, WI 53211
Phone (414) 270-1633

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1659936169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 E ELM RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531546478",
            "telephone_number": "414-313-8561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-271-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSZAK",
        "first_name": "CADIE",
        "middle_name": "LEIGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.