NPIMap

Individual provider Active NPI

Cornelia B Masak, RN, APNP

  • Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1740319516
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
93688 Issued in WI
Practice address
1818 N Meade St
Appleton, WI 54911-3454
Phone
(920) 749-4000
Fax
(920) 749-4015
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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 93688 WI Primary

Addresses

Primary practice location

1818 N Meade St
Appleton, WI 54911-3454

Mailing address

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 749-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804003604 WI Practitioner - Nurse Practitioner 8224499306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Health Specialists SCGroup PAC ID 8628044138, 27 clinicians

Practice addresses (Care Compare)

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 749-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93688WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Health Specialists, S.C. CurrentSince Jun 19, 2023 Accepting new patients
Fox Valley Perinatology, S.C. Past Accepting new patients

Locations

1818 N Meade St
Ste 330
Appleton, WI 54911
Phone (920) 749-4000

2500 E Capitol Dr
Ste 1650
Appleton, WI 54911
Phone (920) 749-4000

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

Interoperability endpoints

  • Direct secure messaging: cmasak4147@direct.thedacare.org

Organizations & group practices 2

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 12

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1740319516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-749-4000",
            "fax_number": "920-749-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-749-4000",
            "fax_number": "920-749-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASAK",
        "first_name": "CORNELIA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "RN, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "93688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.