Individual provider Active NPI

Marcia Meyer, APNP

  • Gerontology Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1699463414
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
13905-33 Issued in WI
Practice address
N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone
(262) 875-5070
Fax
(866) 384-9486
NPI assigned
Apr 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 13905-33 WI Primary

Addresses

Primary practice location

N20W22961 Watertown Rd
Waukesha, WI 53186-1306

Mailing address

W2833 Roosevelt Rd
Ixonia, WI 53036-9522

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
I20230705002175 WI Practitioner - Nurse Practitioner 7315951100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Medical SCGroup PAC ID 0042595175, 118 clinicians
Maple Medical SCGroup PAC ID 9032471248, 25 clinicians

Practice addresses (Care Compare)

121 Hospital Dr
Watertown, WI 53098-3303
Phone (920) 261-9220

N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone (262) 875-5070

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13905-33WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Medical SC CurrentSince Jun 1, 2023 Accepting new patients
Oak Medical SC CurrentSince Jun 1, 2023 Accepting new patients

Locations

121 Hospital Dr
Watertown, WI 53098
Phone (920) 261-9220

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

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": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1699463414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2833 ROOSEVELT RD",
            "city": "IXONIA",
            "state": "WI",
            "postal_code": "530369522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "MARCIA",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "13905-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.