Individual provider Active NPI

Alysia M. Krueger, APNP

  • Family Nurse Practitioner
  • Middleton, WI
National Provider Identifier
1770920779
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14368-33 Issued in WI
Practice address
3030 Laura LN Ste 130
Middleton, WI 53562-1872
Phone
(888) 688-4746
Fax
(608) 960-7789
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14368-33 WI Primary

Addresses

Primary practice location

3030 Laura LN Ste 130
Middleton, WI 53562-1872

Mailing address

3030 Laura LN Ste 130
Middleton, WI 53562-1872
Phone (888) 688-4746

Other names 1

  • Alysia M. Moen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180702000490 GA Practitioner - Nurse Practitioner 3870734833 Reassigns benefits to 1 organization
I20230913001522 WI Practitioner - Nurse Practitioner 3870734833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

109 Air Park Dr
Watertown, WI 53094-7400
Phone (262) 928-5100

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Care Medical Center LLC CurrentSince Apr 1, 2018 Accepting new patients
Care Medical Center LLC CurrentSince Apr 1, 2018 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Jan 1, 2025 Accepting new patients
Prohealth Medical Group Inc CurrentSince Jan 1, 2025 Accepting new patients
Pivotal Health, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

2804 N Oak St
Ste C
Valdosta, GA 31602
Phone (229) 241-8925

3030 Laura Ln
Ste 130
Middleton, WI 53562
Phone (888) 688-4746

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/23915/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 3

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": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1770920779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 LAURA LN STE 130",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535621872",
            "telephone_number": "888-688-4746",
            "fax_number": "608-960-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 LAURA LN STE 130",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535621872",
            "telephone_number": "888-688-4746",
            "fax_number": "608-960-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "ALYSIA",
        "middle_name": "M.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "14368-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSIA",
            "last_name": "MOEN",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middleton, WI

Sources for this page

Verify at the official NPI Registry.