Individual provider Active NPI

Marianne H Mainhardt, NP

  • Nurse Practitioner
  • Marinette, WI
National Provider Identifier
1932290004
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1565 Issued in WI
Practice address
4061 Old Peshtigo Rd
Marinette, WI 54143-3887
Phone
(715) 732-8000
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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 1565 WI Primary

Addresses

Primary practice location

4061 Old Peshtigo Rd
Marinette, WI 54143-3887

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1510 University Dr
Marinette, WI 54143-4131
Phone (715) 735-3998

Other identifiers 1

IdentifierTypeStateIssuer
36013400MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mmainhardt55988@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061020000448 WI Practitioner - Nurse Practitioner 5698772382 Reassigns benefits to 1 organization
I20240108005514 MI Practitioner - Nurse Practitioner 5698772382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2408 10TH St
Menominee, MI 49858-2004
Phone (906) 863-4100

4061 Old Peshtigo Rd
Marinette, WI 54143-3887
Phone (715) 732-8000

Hospital & facility affiliations

  • Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1565WIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 23, 2006 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 23, 2006 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 4, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

2408 10th St
Menominee, MI 49858
Phone (906) 863-4100

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

123 N Military Ave
Green Bay, WI 54303
Phone (920) 494-3421

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

3130 Shore Dr
Marinette, WI 54143
Phone (715) 735-7421

1510 University Dr
Marinette, WI 54143
Phone (715) 735-3998

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

530 Smith Ave
Oconto, WI 54153
Phone (920) 834-7600

Organizations & group practices 4

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 3

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1932290004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 OLD PESHTIGO RD",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433887",
            "telephone_number": "715-732-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 University Dr",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541434131",
            "country_code": "US",
            "telephone_number": "715-735-3998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAINHARDT",
        "first_name": "MARIANNE",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36013400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1510 University Dr",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541434131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmainhardt55988@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "1510 University Dr",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541434131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.