Active NPI
Nicolette Deveneau
- Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
- License
- 54414
- Practice address
- 2350 N Lake Dr
Suite 504
Milwaukee, WI 53211-4528 - Phone
- (414) 289-9668
- Fax
- (414) 289-0974
- NPI assigned
- Apr 11, 2008
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | TP | KY | |
| Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician | 2088F0040X | 54414 | WI | Primary |
Addresses
Primary practice location
2350 N Lake Dr
Suite 504
Milwaukee, WI 53211-4528
Mailing address
4425 N Port Washington Rd
Glendale, WI 53212-1082
Phone (414) 326-2218
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Texas Medical School at San Antonio, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2350 N Lake Dr
Suite 501
Milwaukee, WI 53211-4528
Phone (414) 298-7171
Hospital & facility affiliations
- Ascension Columbia St Marys Hospital Milwaukee
- Ascension SE Wisconsin Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Madison Medical Affiliates, Inc. | Current | Accepting new patients | |
| Columbia St. Mary'S Hospital Milwaukee, Inc | Current | Accepting new patients | |
| Columbia St. Mary'S Hospital Milwaukee Inc | Current | Accepting new patients | |
| The University Gynecological & Obstetrical Foundation, Inc. | Past | Accepting new patients |
Locations
7423 Solutions Ctr
Chicago, IL 60677
788 N Jefferson St
Ste 300
Milwaukee, WI 53202
Phone (414) 272-8950
2350 N Lake Dr
Ste 504
Milwaukee, WI 53211
Phone (414) 289-9668
788 N Jefferson St
Ste 401
Milwaukee, WI 53202
Phone (414) 226-4020
2350 N Lake Dr
Ste 501
Milwaukee, WI 53211
Phone (414) 226-4020
2350 N Lake Dr
Ste 305
Milwaukee, WI 53211
Phone (414) 298-7171
801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600
Interoperability endpoints
- https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4
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.
-
- General Practice Physician
- Milwaukee, WI
- NPI 1588695746
-
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1023064482
-
- Psychiatric Hospital Unit
- Mequon, WI
- NPI 1417600909
-
- Specialist
- Louisville, KY
- NPI 1497700587
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1427007384
-
- Rehabilitation Hospital Unit
- Brookfield, WI
- NPI 1861417362
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1871656082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443139200000",
"number": "1982877866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 N PORT WASHINGTON RD",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532121082",
"telephone_number": "414-326-2218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 N LAKE DR",
"address_2": "SUITE 504",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532114528",
"telephone_number": "414-289-9668",
"fax_number": "414-289-0974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVENEAU",
"first_name": "NICOLETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-11",
"last_updated": "2015-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "KY",
"license": "TP",
"primary": false
},
{
"code": "2088F0040X",
"taxonomy_group": "",
"desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
"state": "WI",
"license": "54414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.