Marie Louise Bruce, APNP

Individual provider Active NPI Nurse Practitioner · Summit, WI

NPI 1760635692 · NPPES record last updated Sep 20, 2022

Key facts

NPI
1760635692
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
3543 (WI)
Practice address
36500 Aurora Dr
Summit, WI 53066
Phone
(262) 434-5000
Fax
(262) 434-5050
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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 1

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

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc. (3,764 clinicians)

Practice addresses (Care Compare)

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

Hospital & facility affiliations

  • Aurora Medical Center - Summit Hospital · Summit, WI · CCN 520206

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 IDStateProvider typePAC IDDetails
I20081218000335 WI Practitioner - Nurse Practitioner 0749342111 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3543WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current
since Jul 9, 2018
Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. Current
since Jul 9, 2018
Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

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

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

Interoperability endpoints

  • Direct secure messaging: mbruce201050@direct.myadvocateaurora.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3543 WI Yes

Addresses

Primary practice location

36500 Aurora Dr
Summit, WI 53066

Mailing address

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

Other identifiers

IdentifierTypeStateIssuer
1760635692MedicaidWI

Other names

  • Marie L. Sobieck Former name

Electronic endpoints

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mbruce201050@direct.myadvocateaurora.org Direct

Other providers in Summit, WI

All providers in Summit, WI · Nurse Practitioner in Wisconsin

Sources for this page

Verify at the official NPI Registry.