Individual provider Active NPI

Heidi Capodarco, APNP

  • Nurse Practitioner
  • Pleasant Prairie, WI
National Provider Identifier
1669992004
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7864-33 Issued in WI
Practice address
9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone
(262) 656-3313
Fax
(262) 653-5850
NPI assigned
Jun 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 131503 WI
Nurse Practitioner 363L00000X 7864-33 WI Primary

Addresses

Primary practice location

9555 76TH St
Pleasant Prairie, WI 53158-1984

Mailing address

6308 8TH Avenue
Medical Staff Office
Kenosah, WI 53143-5031
Phone (262) 656-3313

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
I20171016000845 WI Practitioner - Nurse Practitioner 7315213501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
131503WIMDEmergency Registered Nurse
7864-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. CurrentSince Sep 15, 2017 Accepting new patients
Froedtert South, Inc. Past Accepting new patients
Kenosha Pathology Consultants Past Accepting new patients

Locations

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

6308 8th Ave
Ofc
Kenosha, WI 53143

9555 76th St
Ste 1200
Pleasant Prairie, WI 53158
Phone (262) 671-7300

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

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.

Hospital & facility affiliations 1

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1669992004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "KENOSAH",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-656-3313",
            "fax_number": "262-653-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 76TH ST",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-656-3313",
            "fax_number": "262-653-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPODARCO",
        "first_name": "HEIDI",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WI",
            "license": "131503",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7864-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.