Individual provider Active NPI

Gina M Suchocki

  • Nurse Practitioner
  • Crivitz, WI
National Provider Identifier
1770018756
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7658 Issued in WI
Practice address
112 N US Highway 141
Crivitz, WI 54114-1708
Phone
(715) 854-3940
Fax
(715) 854-3941
NPI assigned
Apr 27, 2017
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7658-33 WI
Nurse Practitioner 363L00000X 7658 WI Primary

Addresses

Primary practice location

112 N US Highway 141
Crivitz, WI 54114-1708

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (715) 854-3940

Other practice location 1

4061 Old Peshtigo Rd
Marinette, WI 54143-3887
Phone (715) 732-8000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gsuchocki187210@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20170719003755 WI Practitioner - Nurse Practitioner 0143590489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

4061 Old Peshtigo Rd
Marinette, WI 54143-3887
Phone (715) 732-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7658-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2020 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2020 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

112 N US Highway 141
Crivitz, WI 54114
Phone (715) 735-6621

3003 University Dr
Marinette, WI 54143
Phone (715) 735-3187

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

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

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Interoperability endpoints

  • Direct secure messaging: gsuchocki187210@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1770018756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "715-854-3940",
            "fax_number": "715-854-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N US HIGHWAY 141",
            "city": "CRIVITZ",
            "state": "WI",
            "postal_code": "541141708",
            "telephone_number": "715-854-3940",
            "fax_number": "715-854-3941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4061 Old Peshtigo Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433887",
            "country_code": "US",
            "telephone_number": "715-732-8000",
            "fax_number": "715-732-8007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUCHOCKI",
        "first_name": "GINA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7658-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gsuchocki187210@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4061 Old Peshtigo Rd",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4061 Old Peshtigo Rd",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crivitz, WI

Sources for this page

Verify at the official NPI Registry.