Individual provider Active NPI

Nicole A Disch, APRN, AGPCNP-BC

  • Nurse Practitioner
  • Janesville, WI
National Provider Identifier
1760839062
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6854-33 Issued in WI
Practice address
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone
(608) 756-6871
Fax
(608) 756-6836
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered Nurse 163WX0200X 170394-30 WI
Nurse Practitioner 363L00000X 6854-33 WI Primary

Addresses

Primary practice location

1000 Mineral Point Ave
Janesville, WI 53548-2940

Mailing address

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6871

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160729001269 WI Practitioner - Nurse Practitioner 2062705924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
170394-30WIMDOncology Registered Nurse
6854-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Jul 1, 2016 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Jul 1, 2016 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Interoperability endpoints

  • Direct secure messaging: ndisch5632@direct.mhemail.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1760839062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6871",
            "fax_number": "608-756-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6871",
            "fax_number": "608-756-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISCH",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "APRN, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "WI",
            "license": "170394-30",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6854-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.