Active NPI
Eva Devorkin
- Family Nurse Practitioner
- Milwaukee, WI
National Provider Identifier
1679394910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 16069-33
- Practice address
- 3338 N Martin Luther King Dr
Milwaukee, WI 53212-1484 - Phone
- (414) 640-5433
- NPI assigned
- Oct 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 16069-33 | WI | Primary |
Addresses
Primary practice location
3338 N Martin Luther King Dr
Milwaukee, WI 53212-1484
Mailing address
3521 N 54TH Blvd
Milwaukee, WI 53216-2803
Phone (414) 731-8665
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3338 N Dr Martin Luther King Jr Dr
Milwaukee, WI 53212-1484
Phone 41464054335
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16069-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shalem Healing, Inc. | Family | Current | Accepting new patients |
Locations
3338 N Martin Luther King Dr
Milwaukee, WI 53212
Phone (414) 640-5433
3338 N Martin Luther King Dr
Fl 2
Milwaukee, WI 53212
Phone (414) 640-5433
Organizations & group practices 1
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": "1729296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729296000000",
"number": "1679394910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3521 N 54TH BLVD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532162803",
"telephone_number": "414-731-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3338 N MARTIN LUTHER KING DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532121484",
"telephone_number": "414-640-5433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVORKIN",
"first_name": "EVA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-19",
"last_updated": "2024-10-19",
"certification_date": "2024-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "16069-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.