Individual provider Active NPI

Andrea Pankratz, WHNP-BC

  • Women's Health Nurse Practitioner
  • Madison, WI
National Provider Identifier
1669739025
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
156864-30 Issued in WI
Practice address
1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone
(608) 252-8000
Fax
(608) 283-7354
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 156864-30 WI Primary

Addresses

Primary practice location

1313 Fish Hatchery Rd
Madison, WI 53715-1911

Mailing address

1313 Fish Hatchery Rd
Madison, WI 53715-1911
Phone (608) 252-8000

Other identifiers 1

IdentifierTypeStateIssuer
391052077MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address apankratz385450@direct-ehr-ssmhc.com Direct

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
I20161020000645 WI Practitioner - Nurse Practitioner 2567762321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Healthcare IncGroup PAC ID 0840189718, 159 clinicians

Practice addresses (Care Compare)

611 E Sherman Ave
Fort Atkinson, WI 53538-1960
Phone (920) 568-5000

611 Sherman Ave E
Fort Atkinson, WI 53538-1960

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4833WIMDProfessional Counselor
156864-30WIMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Healthcare Inc CurrentSince Jul 25, 2024 Accepting new patients
Fort Healthcare Inc CurrentSince Jul 25, 2024 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Aug 7, 2016 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Aug 7, 2016 Accepting new patients
Community Action Inc of Rock & Walworth County Past Accepting new patients

Locations

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

650 McMillen St
Fort Atkinson, WI 53538
Phone (920) 563-8900

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/
  • Direct secure messaging: apankratz385450@direct-ehr-ssmhc.com
  • Direct secure messaging: andrea.pankratz@direct.forthc.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1669739025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151911",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151911",
            "telephone_number": "608-252-8000",
            "fax_number": "608-283-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKRATZ",
        "first_name": "ANDREA",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WI",
            "license": "156864-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391052077",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apankratz385450@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "apankratz385450@direct-ehr-ssmhc.com",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.