Individual provider Active NPI

Abra Seidler

  • Psychiatric/Mental Health Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1689063950
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
167888 Issued in WI
Practice address
1531 S Madison St
Appleton, WI 54915
Phone
(920) 730-4411
NPI assigned
Jan 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6095 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 167888 WI Primary

Addresses

Primary practice location

1531 S Madison St
Appleton, WI 54915

Mailing address

1531 S Madison St
Appleton, WI 54915-1800
Phone (920) 730-4411

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abra.zimmermann.1@10114.direct.athenahealth.com

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
I20150527001142 WI Practitioner - Nurse Practitioner 3476873878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1531 S Madison St
FL 4
Appleton, WI 54915-1800
Phone (920) 996-3700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
167888WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jan 25, 2015 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jan 25, 2015 Accepting new patients

Locations

1531 S Madison St
Appleton, WI 54915
Phone (920) 730-4411

1531 S Madison St
Fl 4
Appleton, WI 54915
Phone (920) 730-2617

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

Organizations & group practices 2

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": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1689063950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151800",
            "telephone_number": "920-730-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54915",
            "telephone_number": "920-730-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDLER",
        "first_name": "ABRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6095",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "167888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abra.zimmermann.1@10114.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1531 S Madison St",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.