Individual provider Active NPI

Madeline Marie Carlson, NP

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1972144376
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9666-33 Issued in WI
Practice address
945 N 12TH St
Milwaukee, WI 53233-1305
Phone
(414) 219-6777
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 9666-33 WI Primary

Addresses

Primary practice location

945 N 12TH St
Milwaukee, WI 53233-1305

Mailing address

1343 N 10TH Ave
West Bend, WI 53090-1813
Phone (920) 655-1038

Other identifiers 1

IdentifierTypeStateIssuer
100094193MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mcarlson183323@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
I20191028002281 WI Practitioner - Nurse Practitioner 1759613524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
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)

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

Hospital & facility affiliations

  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9666WIMDPharmacist
9666-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 24, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 24, 2019 Accepting new patients

Locations

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

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

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

Interoperability endpoints

  • Direct secure messaging: mcarlson183323@direct.myadvocateaurora.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.

Hospital & facility affiliations 1

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": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1972144376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 N 10TH AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901813",
            "telephone_number": "920-655-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "MADELINE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9666-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100094193",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcarlson183323@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "945 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "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": "945 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.