Active NPI
Jessica Pflieger, APNP
- Pediatric Nurse Practitioner
- New Berlin, WI
National Provider Identifier
1922585223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 8507-33
- Practice address
- 4855 S Moorland Rd FL 3
New Berlin, WI 53151-7494 - Phone
- (262) 432-7599
- Fax
- (262) 432-7694
- NPI assigned
- Jul 19, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 8507-33 | WI | Primary |
| Registered Nurse | 163W00000X | 198015-30 | WI |
Addresses
Primary practice location
4855 S Moorland Rd FL 3
New Berlin, WI 53151-7494
Mailing address
1026 N 122ND St
Wauwatosa, WI 53226-3312
Other practice location 1
3440 S 27th St
Milwaukee, WI 53215-4306
Phone (414) 645-1617
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922585223 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198015-30 | WI | MD | Registered Nurse |
| 8507-33 | WI | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samir Mullick MD SC | Past | Accepting new patients | |
| Children'S Health System | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- jpflieger24503@direct.chw.org
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.
-
- Pediatrics Physician
- Milwaukee, WI
- NPI 1235182221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588896000000",
"number": "1922585223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1026 N 122ND ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532263312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 S MOORLAND RD FL 3",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531517494",
"telephone_number": "262-432-7599",
"fax_number": "262-432-7694"
}
],
"practiceLocations": [
{
"address_1": "3440 S 27th St",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532154306",
"country_code": "US",
"telephone_number": "414-645-1617",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PFLIEGER",
"first_name": "JESSICA",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-19",
"last_updated": "2020-05-08",
"certification_date": "2020-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "WI",
"license": "8507-33",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "198015-30",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1922585223",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.