Nicole Ann Kakuk, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12223-33 Issued in WI

Practice address

2300 Western Ave
Manitowoc, WI 54220-3712

Phone

(920) 320-2011

NPI assigned

Dec 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thedacare at Home Home health agency, Appleton, WI, CCN 527010
• Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Froedtert Manitowoc Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment Care Compare group NPD

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

• Holy Family Memorial Inc

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  Care Compare affiliation
• Thedacare, Incorporated

  • Home Health Agency
  • Appleton, WI
  • NPI 1235225210
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1790220044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WESTERN AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203712",
            "telephone_number": "920-320-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 WESTERN AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203712",
            "telephone_number": "920-320-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKUK",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2024-06-07",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "232814 - 30",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "WI",
            "license": "319942",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "12223-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Just Orthodontics, Inc.
• Ethan Just, DMD
• Jeffery Keith Just
• Sarah Kadow
• Laura Kakatsch
• Annette M Kaminsky, APNP
• Sivakami Kangayappan, M.D
• Christopher Michael Kania, DDS
• Carrie Lynn Karbon, RD
• Kathryn Marie Kasper, P.T.A.

• Nurse Practitioner in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.