Individual provider Active NPI

Paula Marie Kasuboski, NP

  • Nurse Practitioner
  • Sun City West, AZ
National Provider Identifier
1801035613
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
315752 Issued in AZ
Practice address
14520 W Granite Valley Dr Ste 120
Sun City West, AZ 85375-5855
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Feb 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3682 WI
Nurse Practitioner 363L00000X 315752 AZ Primary

Addresses

Primary practice location

14520 W Granite Valley Dr Ste 120
Sun City West, AZ 85375-5855

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (866) 974-2673

Other practice location 1

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8880 ext. 4059

Other practice location 2

835 Parkside St
Ripon, WI 54971-8505
Phone (920) 745-3500

Other practice location 3

620 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-5581

Other practice location 4

2205 N Calhoun Rd
Brookfield, WI 53005-5062
Phone (262) 784-2131

Other practice location 5

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Other identifiers 3

IdentifierTypeStateIssuer
100002763MedicaidWI
110643OtherWIWISCONSIN LICENSE NUMBER
368233OtherWINP LICENSE NUMBER

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address pkasuboski491114@direct-ehr-ssmhc.com Direct AGNESIAN HEALTHCARE INC
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other AGNESIAN HEALTHCARE INC
Direct Messaging Address pkasuboski67214@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AZ2 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
I20090513000016 WI Practitioner - Nurse Practitioner 2264581701 Reassigns benefits to 1 organization
I20251021004760 AZ Practitioner - Nurse Practitioner 2264581701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Marian University College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

14520 W Granite Valley Dr
Suite 120
Sun City West, AZ 85375-5855
Phone (866) 974-2673

835 Parkside St
Ripon, WI 54971-8505
Phone (920) 748-3101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
315752AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education LLC CurrentSince Nov 1, 2025 Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 1, 2023 Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 1, 2023 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Center for Orthopedic Research and Education, LLC Nurse Practitioner CurrentSince Nov 1, 2025 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

835 Parkside St
Ripon, WI 54971
Phone (920) 745-3520

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

Interoperability endpoints

  • Direct secure messaging: pkasuboski67214@direct.myadvocateaurora.org
  • Direct secure messaging: paula.kasuboski.1@22724.direct.athenahealth.com
  • Direct secure messaging: pkasuboski491114@direct-ehr-ssmhc.com

Organizations & group practices 6

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 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": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1801035613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14520 W GRANITE VALLEY DR STE 120",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755855",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 N Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549047668",
            "country_code": "US",
            "telephone_number": "920-303-8880 x4059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 Parkside St",
            "address_purpose": "LOCATION",
            "city": "Ripon",
            "state": "WI",
            "postal_code": "549718505",
            "country_code": "US",
            "telephone_number": "920-745-3500",
            "fax_number": "920-745-7930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 W Brown St",
            "address_purpose": "LOCATION",
            "city": "Waupun",
            "state": "WI",
            "postal_code": "539631702",
            "country_code": "US",
            "telephone_number": "920-324-5581",
            "fax_number": "920-926-4875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2205 N Calhoun Rd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055062",
            "country_code": "US",
            "telephone_number": "262-784-2131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 N Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549047668",
            "country_code": "US",
            "telephone_number": "920-303-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASUBOSKI",
        "first_name": "PAULA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3682",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "315752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002763",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN LICENSE NUMBER",
            "identifier": "110643",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "368233",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkasuboski491114@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pkasuboski491114@direct-ehr-ssmhc.com",
            "address_1": "835 Parkside St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549718505",
            "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": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "835 Parkside St",
            "city": "Ripon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549718505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkasuboski67214@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

Verify at the official NPI Registry.