Mohamed Hassan Abdelazim, APNP
Individual provider Active NPI Nurse Practitioner · Appleton, WI
NPI 1760266696 · NPPES record last updated Aug 4, 2026
Key facts
- NPI
- 1760266696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 14429 (WI)
- Practice address
- 1818 N Meade St
Appleton, WI 54911-3454 - Phone
- (920) 731-1401
- NPI assigned
- Aug 22, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Thedacare, Incorporated
Practice addresses (Care Compare)
1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 735-7645
Hospital & facility affiliations
- Thedacare Regional Medical Center - Appleton Inc
- Thedacare Medical Center - Shawano
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20231103002704 | WI | Practitioner - Nurse Practitioner | 0345697900 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14429 | WI | MD | Nurse Practitioner |
| 14429-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare, Incorporated | Current |
Accepting new patients | |
| Thedacare, Incorporated | Current |
Accepting new patients | |
| Thedacare Medical Center - Berlin, Inc. | Past | Accepting new patients |
Locations
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229
1405 Mill St
New London, WI 54961
Phone (920) 531-2000
250 W 6th Ave
Oshkosh, WI 54902
Phone (920) 237-5000
600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 14429 | WI | Yes |
| Family Nurse Practitioner | 363LF0000X | 14429-33 | WI |
Addresses
Primary practice location
1818 N Meade St
Appleton, WI 54911-3454
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 731-8900
Other practice location 1
1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300
Other providers in Appleton, WI
- Abbie Goodman, LLC
- Abbott Family Chiropractic, S.C.
- Gregory Abbott
- Miranda Abbott
- Abc Transportation LLC
- Abdoullah Aboulhassani
- Zenoun O Abouzelam
- Danielle Abraham
- Sarah A Abraham
- Access Valley Transport Inc
All providers in Appleton, 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 Aug 4, 2026. 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.