Mariana Isabel Corpus Hines, APRN
Individual provider Active NPI Nurse Practitioner · Waterford, WI
NPI 1730898396 · NPPES record last updated Oct 14, 2025
Key facts
- NPI
- 1730898396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 16422 (WI)
- Practice address
- 818 Forest LN
Waterford, WI 53185-4585 - Phone
- (262) 514-8199
- Fax
- (262) 514-3851
- NPI assigned
- Nov 22, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wake Specialty Physicians LLC
Aurora Medical Group, Inc.
Practice addresses (Care Compare)
6800 Glenwood Ave
Raleigh, NC 27612-7133
Phone (919) 235-1939
818 Forest LN
Waterford, WI 53185-4585
Phone (262) 514-3700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240426001920 | NC | Practitioner - Nurse Practitioner | 6305217514 | Reassigns benefits to 1 organization |
| I20250711003788 | WI | Practitioner - Nurse Practitioner | 6305217514 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16422 | WI | MD | Nurse Practitioner |
| 11020982 | FL | MD | Family Nurse Practitioner |
Practice roles (10 of 14)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Medical Clinic LTD | Current |
Accepting new patients | |
| Wake Specialty Physicians LLC | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Current |
Accepting new patients | |
| Lakeshore Medical Clinic, LLC | Current |
Accepting new patients | |
| Wake Specialty Physicians, LLC | Nurse Practitioner | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Wake Specialty Physicians LLC | Current |
Accepting new patients | |
| Aurora Advanced Healthcare Inc | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients |
Locations
2216 E NC Highway 54
Durham, NC 27713
Phone (919) 544-2020
3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000
10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300
6800 Glenwood Ave
Raleigh, NC 27612
Phone (919) 235-1939
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747
2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880
818 Forest Ln
Waterford, WI 53185
Phone (262) 514-3700
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- mcorpus549780@directhisp.wakemed.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 16422 | WI | Yes |
| Family Nurse Practitioner | 363LF0000X | 11020982 | FL | |
| Family Nurse Practitioner | 363LF0000X | 5019446 | NC |
Addresses
Primary practice location
818 Forest LN
Waterford, WI 53185-4585
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
2216 E NC Highway 54
Durham, NC 27713-2208
Phone (919) 235-1040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100333585 | Medicaid | WI | |
| 1730898396 | Medicaid | NC |
Other names
- Mariana Isabel Corpus
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | mhines435219@direct.myadvocateaurora.org | Direct |
Other providers in Waterford, WI
- Kristin Gorenc
- Mary Grajewski
- Lisa Haeuser
- Mariah Hanrahan
- Joyanne Hickman
- Robert S Hirschman
- Ihc Hospitalists LLC
- Anwar R Isabell
- Brianne T Jacobson
- Jennifer M. Johnston
All providers in Waterford, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.