NPIMap

Individual provider Active NPI

Tammy L Degenhardt, APNP

  • Family Nurse Practitioner
  • Menomonee Falls, WI
National Provider Identifier
1669770210
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
99873-30 Issued in WI
Practice address
N83W15550 Appleton Ave
Menomonee Falls, WI 53051-3714
Phone
(262) 253-5056
NPI assigned
Mar 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 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 Practitioner 363LF0000X 99873-30 WI Primary

Addresses

Primary practice location

N83W15550 Appleton Ave
Menomonee Falls, WI 53051-3714

Mailing address

N83W15550 Appleton Ave
Menomonee Falls, WI 53051-3714
Phone (262) 253-5056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150323001834 WI Practitioner - Nurse Practitioner 5698092047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Practice addresses (Care Compare)

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

Hospital & facility affiliations

  • Community Memorial Hospital Hospital, Menomonee Falls, WI, CCN 520103
  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99873-30WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 29, 2022 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 29, 2022 Accepting new patients

Locations

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

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

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

Interoperability endpoints

  • Direct secure messaging: tdegenhardt155840@direct.froedtert.com

Organizations & group practices 14

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.

View all 14

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": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1669770210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N83W15550 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513714",
            "telephone_number": "262-253-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N83W15550 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513714",
            "telephone_number": "262-253-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENHARDT",
        "first_name": "TAMMY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "99873-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.