Individual provider Active NPI

Rebecca Mae Rettler, APNP

  • Family Nurse Practitioner
  • Sussex, WI
National Provider Identifier
1699498535
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13170-33 Issued in WI
Practice address
N57W24950 N Corporate Cir
Sussex, WI 53089-4383
Phone
(262) 820-3093
NPI assigned
Sep 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 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 13170-33 WI Primary

Addresses

Primary practice location

N57W24950 N Corporate Cir
Sussex, WI 53089-4383

Mailing address

W384N8280 Highlander Dr
Oconomowoc, WI 53066-9654
Phone (262) 719-0292

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rebecca.rettler@phci.org Direct

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
I20221018001735 WI Practitioner - Nurse Practitioner 5092181990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

717 W Moreland Blvd
Waukesha, WI 53188-2432
Phone (262) 542-9100

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

N57W24950 N Corporate Cir
Sussex, WI 53089-4383
Phone (262) 820-3093

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13170-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Oct 1, 2022 Accepting new patients
Prohealth Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients

Locations

N57W24950 N Corporate Cir
Sussex, WI 53089
Phone (262) 544-4411

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

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

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 3

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": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1699498535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W384N8280 HIGHLANDER DR",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530669654",
            "telephone_number": "262-719-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N57W24950 N CORPORATE CIR",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530894383",
            "telephone_number": "262-820-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTLER",
        "first_name": "REBECCA",
        "middle_name": "MAE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "13170-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca.rettler@phci.org",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "N57W24950 N Corporate Cir",
            "city": "Sussex",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530894383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sussex, WI

Sources for this page

Verify at the official NPI Registry.