Individual provider Active NPI

Colleen K Micele, FNP

  • Nurse Practitioner
  • Oshkosh, WI
National Provider Identifier
1710079231
Registry record updated Nov 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2935-33 Issued in WI
Practice address
135 Jackson St
Oshkosh, WI 54901-4713
Phone
(920) 303-8100
Fax
(920) 745-4701
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2935 WI
Nurse Practitioner 363L00000X 2935-33 WI Primary

Addresses

Primary practice location

135 Jackson St
Oshkosh, WI 54901-4713

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
36020500MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cmicele42464@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
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
I20061117000304 WI Practitioner - Nurse Practitioner 5698773141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1242 W Fond Du Lac St
Ripon, WI 54971-9288
Phone (920) 745-4700

Hospital & facility affiliations

  • Aurora Medical Ctr Oshkosh Hospital, Oshkosh, WI, CCN 520198

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2938WIMDGeneral Practice Dentistry
2935WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Dec 1, 2009 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 1, 2009 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Community Medical Center of Green Lake, LLC Past Accepting new patients
Jeffrey G. Bentson, M.D., PLLC Past Accepting new patients

Locations

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000

12500 W Bluemound Rd
Elm Grove, WI 53122
Phone (262) 780-3434

210 Wisconsin American Dr
Fond du Lac, WI 54937
Phone (920) 907-7000

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

N1750 Lily of the Valley Dr
Greenville, WI 54942
Phone (920) 757-5170

375 East Ave
Lomira, WI 53048
Phone (920) 269-2060

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

1136 Westowne Dr
Neenah, WI 54956
Phone (920) 456-2030

700 Park Ridge Ln
North Fond du Lac, WI 54937
Phone (920) 907-7450

1805 Huckleberry Ave
Omro, WI 54963
Phone (920) 685-7280

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

700 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 456-2030

414 Doctors Ct
Oshkosh, WI 54901
Phone (920) 303-5020

135 Jackson St
Oshkosh, WI 54901
Phone (920) 236-3277

1242 W Fond du Lac St
Ripon, WI 54971
Phone (920) 722-7747

900 E Division St
Wautoma, WI 54982
Phone (920) 787-0837

6085 Harbour View Dr
Winneconne, WI 54986
Phone (920) 582-0600

Interoperability endpoints

  • Direct secure messaging: cmicele42464@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 1

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731801600000",
    "number": "1710079231",
    "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": "135 JACKSON ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549014713",
            "telephone_number": "920-303-8100",
            "fax_number": "920-745-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELE",
        "first_name": "COLLEEN",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2935",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2935-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36020500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmicele42464@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1242 W Fond Du Lac St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549719288",
            "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": "1242 W Fond Du Lac St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549719288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.