Individual provider Active NPI

Colleen Jo Sobocinski, APNP

  • Family Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1689943631
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4727-33 Issued in WI
Practice address
801 E Sunset Dr
Waukesha, WI 53189-7816
Phone
(262) 532-3691
NPI assigned
Dec 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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 4727-33 WI Primary

Addresses

Primary practice location

801 E Sunset Dr
Waukesha, WI 53189-7816

Mailing address

801 E Sunset Dr
Waukesha, WI 53189-7816
Phone (262) 532-3691

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
I20130613000065 WI Practitioner - Nurse Practitioner 4385883875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5800 W Layton Ave
Greenfield, WI 53220-4021
Phone (262) 532-3067

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4727-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 18, 2022 Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 18, 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

801 E Sunset Dr
Waukesha, WI 53189
Phone (262) 532-3691

20611 Watertown Rd
Ste J
Waukesha, WI 53186
Phone (262) 782-0000

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

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

Interoperability endpoints

  • Direct secure messaging: csobocinski155718@direct.froedtert.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1689943631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E SUNSET DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897816",
            "telephone_number": "262-532-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E SUNSET DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897816",
            "telephone_number": "262-532-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOCINSKI",
        "first_name": "COLLEEN",
        "middle_name": "JO",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-20",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4727-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.