Active NPI
Traci Anna Eliszewski, APNP
- Nurse Practitioner
- Madison, WI
National Provider Identifier
1851817050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 8496-033
- Practice address
- 700 S Park St
Madison, WI 53715-1830 - Phone
- (608) 251-6100
- NPI assigned
- Aug 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 8496-033 | WI | Primary |
Addresses
Primary practice location
700 S Park St
Madison, WI 53715-1830
Mailing address
1808 W Beltline Hwy
Madison, WI 53713-2334
Phone (608) 250-1497
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851817050 | Medicaid | WI |
Other names 1
- Traci A Wileman-Eliszewski
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | twilemaneliszewski272388@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 14, 2021 through Oct 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8496-033 | WI | MD | Nurse Practitioner |
Interoperability endpoints
- twilemaneliszewski272388@direct-ehr-ssmhc.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605052800000",
"number": "1851817050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 W BELTLINE HWY",
"city": "MADISON",
"state": "WI",
"postal_code": "537132334",
"telephone_number": "608-250-1497",
"fax_number": "608-250-1384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151830",
"telephone_number": "608-251-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELISZEWSKI",
"first_name": "TRACI",
"middle_name": "ANNA",
"name_prefix": "Mrs.",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-18",
"last_updated": "2020-11-11",
"certification_date": "2020-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "8496-033",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1851817050",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "twilemaneliszewski272388@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "twilemaneliszewski272388@direct-ehr-ssmhc.com",
"address_1": "700 S Park St",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537151830",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "700 S Park St",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537151830",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "TRACI",
"last_name": "WILEMAN-ELISZEWSKI",
"middle_name": "A",
"credential": "APNP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.