NPIMap

Individual provider Active NPI

Brandi Zimbelman, NP-C

  • Nurse Practitioner
  • Baraboo, WI
National Provider Identifier
1730482258
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP129734 Issued in TX
Practice address
515 South Blvd
Ste C
Baraboo, WI 53913-2888
Phone
(608) 844-0496
Fax
(616) 326-9554
NPI assigned
Dec 6, 2010
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP129734 TX Primary

Addresses

Primary practice location

515 South Blvd
Ste C
Baraboo, WI 53913-2888

Mailing address

515 South Blvd
Ste C
Baraboo, WI 53913-2888
Phone (608) 844-0496

Other identifiers 1

IdentifierTypeStateIssuer
1730482258MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161021000059 TX Practitioner - Nurse Practitioner 4082896931 Reassigns benefits to 1 organization
I20180327001803 WI Practitioner - Nurse Practitioner 4082896931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Health and WellnessGroup PAC ID 7517366073, 2 clinicians

Practice addresses (Care Compare)

515 S Blvd
Suite C
Baraboo, WI 53913-2888
Phone (608) 844-0496

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.62 of 100Reported as group
Quality
94.84
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP129734TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Health and Wellness CurrentSince Mar 9, 2021 Accepting new patients
North Houston Heart and Vascular Associates, PA CurrentSince Aug 8, 2016 Accepting new patients
Geodax Imaging, LLC Past Accepting new patients
Cardiology Associates of the Carolinas PA PastSince Dec 27, 2019 Accepting new patients

Locations

24040 Highway 59 N
Kingwood, TX 77339
Phone (281) 312-0242

515 South Blvd
Ste C
Baraboo, WI 53913
Phone (608) 844-0496

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1730482258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SOUTH BLVD",
            "address_2": "STE C",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132888",
            "telephone_number": "608-844-0496",
            "fax_number": "616-326-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 SOUTH BLVD",
            "address_2": "STE C",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132888",
            "telephone_number": "608-844-0496",
            "fax_number": "616-326-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMBELMAN",
        "first_name": "BRANDI",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP129734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730482258",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.