NPIMap

Individual provider Active NPI

Rebecca M. Vissers, APNP

  • Primary Care Nurse Practitioner
  • Oconto, WI
National Provider Identifier
1932370855
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
3376-33 Issued in WI
Practice address
620 Smith Ave
Oconto, WI 54153-1080
Phone
(920) 496-4700
Fax
(920) 834-4117
NPI assigned
Mar 19, 2008
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 3376-33 WI Primary

Addresses

Primary practice location

620 Smith Ave
Oconto, WI 54153-1080

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other identifiers 1

IdentifierTypeStateIssuer
36061200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080502000591 WI Practitioner - Nurse Practitioner 3476632357 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2793 Lineville Rd
Green Bay, WI 54313-7152
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3376WIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jun 1, 2019 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jun 1, 2019 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jun 1, 2019 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jun 1, 2019 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jun 1, 2019 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jun 1, 2019 Accepting new patients
Prevea Regional Services, Inc. Past Accepting new patients

Locations

1715 Dousman St
Green Bay, WI 54303

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

2793 Lineville Rd
Howard, WI 54313

620 Smith Ave
Oconto, WI 54153
Phone (920) 834-4110

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1932370855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700",
            "fax_number": "920-834-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SMITH AVE",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541531080",
            "telephone_number": "920-496-4700",
            "fax_number": "920-834-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISSERS",
        "first_name": "REBECCA",
        "middle_name": "M.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "3376-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36061200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconto, WI

Sources for this page

Verify at the official NPI Registry.