Individual provider Active NPI

Denine Eva Murn, MPAS, PA-C

  • Physician Assistant
  • West Bend, WI
National Provider Identifier
1730673955
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4528-23 Issued in WI
Practice address
3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone
(262) 836-7300
NPI assigned
Jun 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4528-23 WI Primary

Addresses

Primary practice location

3200 Pleasant Valley Rd
West Bend, WI 53095-9274

Mailing address

3200 Pleasant Valley Rd FL 2
West Bend, WI 53095-9274
Phone (262) 836-7300

Other identifiers 1

IdentifierTypeStateIssuer
100083785MedicaidWI

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
I20190104002092 WI Practitioner - Physician Assistant 8729324207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

3212 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 334-6165

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

W180N8085 Town Hall Rd
FL 3
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4528-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince May 19, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince May 19, 2023 Accepting new patients
The Medical College of Wisconsin, Inc. Current 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

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

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

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

3200 Pleasant Valley Rd
Fl 2
West Bend, WI 53095

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: danagnoustopolous645629@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.

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1730673955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD FL 2",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-836-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-836-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURN",
        "first_name": "DENINE",
        "middle_name": "EVA",
        "name_prefix": "Mrs.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4528-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100083785",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.