Individual provider Active NPI

Abby J Andris, APNP

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1851647564
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4949-33 Issued in WI
Practice address
5434 W Capitol Dr
Unit 3
Milwaukee, WI 53216-2298
Phone
(414) 875-0505
NPI assigned
Jul 31, 2012
Last updated
Feb 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4949-33 WI Primary

Addresses

Primary practice location

5434 W Capitol Dr
Unit 3
Milwaukee, WI 53216-2298

Mailing address

5434 W Capitol Dr
Unit 3
Milwaukee, WI 53216-2298
Phone (414) 875-0505

Other identifiers 1

IdentifierTypeStateIssuer
1851647564MedicaidWI

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
I20120914000582 WI Practitioner - Nurse Practitioner 7911155031 Reassigns benefits to 1 organization

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
Sheboygan Physicians Group S.C.Group PAC ID 0648435214, 15 clinicians

Practice addresses (Care Compare)

2920 Superior Ave
Sheboygan, WI 53081-1944
Phone (920) 452-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4949WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheboygan Physicians Group, SC CurrentSince Feb 11, 2019 Accepting new patients

Locations

2920 Superior Ave
Sheboygan, WI 53081
Phone (920) 452-6000

3431 N 13th St
Sheboygan, WI 53083
Phone (920) 457-4054

Organizations & group practices 1

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 6

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": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1851647564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5434 W CAPITOL DR",
            "address_2": "UNIT 3",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162298",
            "telephone_number": "414-875-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5434 W CAPITOL DR",
            "address_2": "UNIT 3",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162298",
            "telephone_number": "414-875-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRIS",
        "first_name": "ABBY",
        "middle_name": "J",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4949-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851647564",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.