Active NPI
Brenda M Veldboom, NP
- Nurse Practitioner
- Random Lake, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3202-033
- Practice address
- 110 Butler St
Random Lake, WI 53075-1708 - Phone
- (920) 994-9094
- NPI assigned
- Sep 6, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3202-033 | WI | Primary |
Addresses
Primary practice location
110 Butler St
Random Lake, WI 53075-1708
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
1001 Service Rd
Kiel, WI 53042-1295
Phone (920) 849-7620
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2007004590 | Other | WI | ANCC |
| 36042200 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bveldboom45038@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
Enrollment records 1
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)
110 Butler St
Random Lake, WI 53075-1708
Phone (920) 994-9094
Hospital & facility affiliations
- Aurora at Home
- Aurora Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3202-033 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Quick Care, LLC | Nurse Practitioner | Past | Accepting new patients |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
313 S Main St
Cedar Grove, WI 53013
Phone (414) 668-8502
1001 Service Rd
Kiel, WI 53042
Phone (920) 894-2636
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
110 Butler St
Random Lake, WI 53075
Phone (920) 994-9094
1813 Ashland Ave
Sheboygan, WI 53081
Phone (920) 458-4010
620 S Wisconsin Dr
Sheboygan, WI 53083
Phone (920) 565-4595
2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461
1146 Plankview Green Blvd
Sheboygan Falls, WI 53085
Phone (920) 457-2424
Interoperability endpoints
- bveldboom45038@direct.myadvocateaurora.org
Organizations & group practices 5
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
-
- Nurse Practitioner
- Mequon, WI
- NPI 1609820729
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grafton, WI
- NPI 1265740195
-
- Home Health Agency
- Green Bay, WI
- NPI 1932361763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757980800000",
"number": "1992990667",
"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": "110 BUTLER ST",
"city": "RANDOM LAKE",
"state": "WI",
"postal_code": "530751708",
"telephone_number": "920-994-9094"
}
],
"practiceLocations": [
{
"address_1": "1001 Service Rd",
"address_purpose": "LOCATION",
"city": "Kiel",
"state": "WI",
"postal_code": "530421295",
"country_code": "US",
"telephone_number": "920-849-7620",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VELDBOOM",
"first_name": "BRENDA",
"middle_name": "M",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-06",
"last_updated": "2025-09-16",
"certification_date": "2025-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "3202-033",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANCC",
"identifier": "2007004590",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36042200",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bveldboom45038@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1001 Service Rd",
"city": "Kiel",
"state": "WI",
"country_code": "US",
"postal_code": "530421295",
"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": "1001 Service Rd",
"city": "Kiel",
"state": "WI",
"country_code": "US",
"postal_code": "530421295",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Random Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.