Individual provider Active NPI

Shannon A Ziska

  • Family Nurse Practitioner
  • Fitchburg, WI
National Provider Identifier
1902557218
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11445-33 Issued in WI
Practice address
2673 Mica Rd
Fitchburg, WI 53711-4929
Phone
(715) 450-1616
NPI assigned
Jan 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11445-33 WI Primary

Addresses

Primary practice location

2673 Mica Rd
Fitchburg, WI 53711-4929

Mailing address

2673 Mica Rd
Fitchburg, WI 53711-4929
Phone (715) 450-1616

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
I20220408002156 WI Practitioner - Nurse Practitioner 3375939846 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agrace Palliative Care LLCGroup PAC ID 4385882729, 9 clinicians

Practice addresses (Care Compare)

5395 E Cheryl Pkwy
Madison, WI 53711-5395
Phone (608) 276-4660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Medical SC CurrentSince Oct 1, 2022 Accepting new patients
Agrace Palliative Care LLC CurrentSince Apr 3, 2023 Accepting new patients

Locations

5395 E Cheryl Pkwy
Fitchburg, WI 53711
Phone (608) 276-4660

1810 Kensington Dr
Waukesha, WI 53188
Phone (262) 548-1400

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.

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1902557218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2673 MICA RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537114929",
            "telephone_number": "715-450-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2673 MICA RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537114929",
            "telephone_number": "715-450-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISKA",
        "first_name": "SHANNON",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11445-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

Verify at the official NPI Registry.