Alyssa Rose Forslin

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10987 Issued in WI

Practice address

710 Park Ave
Waupaca, WI 54981-1956

Phone

(920) 720-2300

NPI assigned

Jun 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aforslin278319@direct.thedacare.org

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.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment Care Compare group NPD
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  NPD (past)
• Thedacare, Incorporated

  • Counselor
  • Menasha, WI
  • NPI 1306959515
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Thedacare Medical Center - Waupaca, Inc.

  • Critical Access Hospital
  • Waupaca, WI
  • NPI 1013995521
  Care Compare affiliation
• Thedacare Medical Center - Waupaca, Inc.

  • Critical Access Hospital
  • Waupaca, WI
  • NPI 1710333893
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1730756909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-720-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 PARK AVE",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811956",
            "telephone_number": "920-720-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811941",
            "country_code": "US",
            "telephone_number": "715-256-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORSLIN",
        "first_name": "ALYSSA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10987-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10987",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "10987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael Fico, PHD
• Melissa A Flease, RDH
• Tammy M Flynn, APNP,PMHNP
• Dennis D Ford, MD
• Forefront Dermatology, S.C.
• Fox Valley Hematology & Oncology, S.C.
• Becky L Franz, M.S. CCC-A
• Carol Lynn Freeman, REGISTERED NURSE
• Alison Wismer Fries, PHD
• Nancy Fugate, P.T.

• Psychiatric/Mental Health Nurse Practitioner in Waupaca, WI
• Providers in Waupaca, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.