Individual provider Active NPI

My See Luangla, APNP

  • Nurse Practitioner
  • Neenah, WI
National Provider Identifier
1861749293
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
147753-30 Issued in WI
Practice address
101 Main St
Neenah, WI 54956-2570
Phone
(920) 727-4420
NPI assigned
Aug 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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 147753-30 WI Primary

Addresses

Primary practice location

101 Main St
Neenah, WI 54956-2570

Mailing address

101 Main St
Neenah, WI 54956-2570
Phone (920) 727-4420

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
I20121108000298 WI Practitioner - Nurse Practitioner 9335390970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Wisconsin School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group-Fox Valley Wisconsin, IncGroup PAC ID 0244142420, 260 clinicians

Practice addresses (Care Compare)

101 Main St
Neenah, WI 54956-2570
Phone (920) 727-4200

Hospital & facility affiliations

  • Ascension NE Wisconsin - St Elizabeth Campus Hospital, Appleton, WI, CCN 520009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4899WIMDPediatric Surgery Physician
147753-30WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince May 1, 2018 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince May 1, 2018 Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

101 Main St
Neenah, WI 54956
Phone (920) 727-4200

1712 Monroe St
New Holstein, WI 53061
Phone (920) 882-4000

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

Organizations & group practices 2

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 2

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": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1861749293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562570",
            "telephone_number": "920-727-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562570",
            "telephone_number": "920-727-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUANGLA",
        "first_name": "MY SEE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "147753-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.