Individual provider Active NPI

Maggie Rose Friede, APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1891389706
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
14461-33 Issued in WI
Practice address
N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone
(262) 875-5070
Fax
(866) 384-9486
NPI assigned
Feb 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14461-33 WI Primary
Registered Nurse 163W00000X 249223 WI

Addresses

Primary practice location

N20W22961 Watertown Rd
Waukesha, WI 53186-1306

Mailing address

701 S Grand Ave
Waukesha, WI 53186-6125
Phone (630) 240-5021

Other practice location 1

701 S Grand Ave
Waukesha, WI 53186-6125
Phone (630) 240-5021

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
I20231024002782 WI Practitioner - Nurse Practitioner 4385090570 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trilogy Health Group LLCGroup PAC ID 7113304692, 2 clinicians

Practice addresses (Care Compare)

2717 N Grandview Blvd
Suite 103
Waukesha, WI 53188-1672
Phone (262) 565-6202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249223WIMDRegistered Nurse
14461-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Medical SC Psychiatric/Mental Health CurrentSince Nov 1, 2023 Accepting new patients
Maple Medical SC CurrentSince Nov 1, 2023 Accepting new patients
Trilogy Health Group LLC Psychiatric/Mental Health CurrentSince Nov 1, 2023 Accepting new patients

Locations

1300 W Silver Spring Dr
Glendale, WI 53209
Phone (414) 228-8120

2717 N Grandview Blvd
Ste 103
Waukesha, WI 53188
Phone (262) 565-6202

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1891389706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S GRAND AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531866125",
            "telephone_number": "630-240-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 S Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531866125",
            "country_code": "US",
            "telephone_number": "630-240-5021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIEDE",
        "first_name": "MAGGIE",
        "middle_name": "ROSE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "14461-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "249223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.