Individual provider Active NPI

Nancy S Asencio, APNP

  • Nurse Practitioner
  • Lake Geneva, WI
National Provider Identifier
1962410530
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
134897-030 Issued in WI
Practice address
146 E Geneva SQ
Lake Geneva, WI 53147
Phone
(262) 249-5000
Fax
(262) 249-7142
NPI assigned
Aug 3, 2006
Last updated
May 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1853-033 WI
Nurse Practitioner 363L00000X 134897-030 WI Primary

Addresses

Primary practice location

146 E Geneva SQ
Lake Geneva, WI 53147

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 647-6326

Other identifiers 1

IdentifierTypeStateIssuer
43938100MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nasencio42279@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20100130000027 WI Practitioner - Nurse Practitioner 8022151075

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

146 E Geneva Square
Lake Geneva, WI 53147-9694

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
134897-030WIMDNurse Practitioner
1853-033WIMDNurse Practitioner

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1962410530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-647-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 E GENEVA SQ",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "53147",
            "telephone_number": "262-249-5000",
            "fax_number": "262-249-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASENCIO",
        "first_name": "NANCY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1853-033",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "134897-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43938100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nasencio42279@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "146 E Geneva Sq",
            "city": "Lake Geneva",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53147",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "146 E Geneva Sq",
            "city": "Lake Geneva",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

Verify at the official NPI Registry.