Individual provider Active NPI

Kaylen M Snoda, APNP

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1669424420
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1703 Issued in WI
Practice address
945 N 12TH St
Womens Health Service
Milwaukee, WI 53233-1305
Phone
(414) 219-5633
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1703 WI
Nurse Practitioner 363L00000X 1703 WI Primary

Addresses

Primary practice location

945 N 12TH St
Womens Health Service
Milwaukee, WI 53233-1305

Mailing address

2012 Harris Highland Dr
Waukesha, WI 53188-4806

Other identifiers 2

IdentifierTypeStateIssuer
41256400MedicaidWI
004856578EOtherHUMANA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksnoda22321@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050216000760 WI Practitioner - Nurse Practitioner 3375595424 Reassigns benefits to 3 organizations
I20230708000171 IL Practitioner - Nurse Practitioner 3375595424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

950 N 12TH St
Milwaukee, WI 53233-1306
Phone (414) 219-7956

9555 S 52ND Ave
Oak Lawn, IL 60453-3054
Phone (708) 634-0950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1703WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Jun 1, 2023 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jun 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 6, 2009 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 15, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 6, 2009 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jun 1, 2023 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 15, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
The Medical College of Wisconsin, Inc. Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9555 S 52nd Ave
Oak Lawn, IL 60453
Phone (708) 422-5700

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

950 N 12th St
Milwaukee, WI 53233
Phone (414) 219-6036

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

915 Summit Ave
Summit, WI 53066
Phone (262) 569-2300

Organizations & group practices 10

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1669424420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 HARRIS HIGHLAND DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531884806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "address_2": "WOMENS HEALTH SERVICE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNODA",
        "first_name": "KAYLEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "1703",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41256400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "004856578E",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksnoda22321@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "945 N 12th St",
            "address_2": "Womens Health Service",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "945 N 12th St",
            "address_2": "Womens Health Service",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.