Individual provider Active NPI

Nicole Anne Parulski, DPT

  • Physical Therapist
  • Port Washington, WI
National Provider Identifier
1679814537
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12252-24 Issued in WI
Practice address
1475 W Grand Ave
Port Washington, WI 53074-2074
Phone
(262) 268-5100
NPI assigned
Mar 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12252-24 WI Primary

Addresses

Primary practice location

1475 W Grand Ave
Port Washington, WI 53074-2074

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

2301 North Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1066

Other identifiers 1

IdentifierTypeStateIssuer
100028525MedicaidWI

Other names 1

  • Nicole Anne Huvaere Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nparulski365247@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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250326001812 WI Practitioner - Physical Therapist in Private Practice 0345763728 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12252-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic LTD CurrentSince Jan 23, 2025 Accepting new patients
Lakeshore Medical Clinic, LLC Physical Therapist CurrentSince Jan 23, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 23, 2025 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jan 23, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 23, 2025 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 23, 2025 Accepting new patients

Locations

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

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

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

4448 W Loomis Rd
Milwaukee, WI 53220
Phone (414) 281-5150

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

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

1475 W Grand Ave
Port Washington, WI 53074
Phone (262) 268-5100

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

Organizations & group practices 6

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": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1679814537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 W GRAND AVE",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530742074",
            "telephone_number": "262-268-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 North Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53211",
            "country_code": "US",
            "telephone_number": "414-291-1066",
            "fax_number": "414-291-1077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARULSKI",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12252-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100028525",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nparulski365247@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1475 W Grand Ave",
            "city": "Port Washington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530742074",
            "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": "1475 W Grand Ave",
            "city": "Port Washington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530742074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HUVAERE",
            "middle_name": "ANNE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Washington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.