Keelyn Marie Wallenfang, APNP in Appleton, WI

Keelyn Marie Wallenfang, APNP is a medicare enrolled "Nurse Practitioner" in Appleton, Wisconsin. Her current practice location is 1818 N Meade St, Appleton, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 731-8900.

Keelyn Marie Wallenfang is licensed to practice in Wisconsin (license number 12184) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669198313.

Contact Information

	Keelyn Marie Wallenfang, APNP
	1818 N Meade St, Appleton, WI 54911-3454
	(920) 731-8900
	(920) 738-5369

Map and Direction

Provider's Profile

Full Name	Keelyn Marie Wallenfang
Gender	Female
Speciality	Nurse Practitioner
Location	1818 N Meade St, Appleton, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1669198313
Provider Enumeration Date: 10/14/2022
Last Update Date: 12/22/2022

Medicare PECOS Information:

PECOS PAC ID: 9234507609
Enrollment ID: I20221116002700

Medical Identifiers

Medical identifiers for Keelyn Marie Wallenfang such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669198313	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	12184 (Wisconsin)	Secondary
363L00000X	Nurse Practitioner	12184 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Keelyn Marie Wallenfang allows following entities to bill medicare on her behalf.

Entity Name	Thedacare, Incorporated
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376656959 PECOS PAC ID: 1759294887 Enrollment ID: O20031106000088

Entity Name	Thedacare Medical Center - Shawano, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548260839 PECOS PAC ID: 5890605836 Enrollment ID: O20031117000117

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keelyn Marie Wallenfang is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Keelyn Marie Wallenfang, APNP 1818 N Meade St, Appleton, WI 54911-3454 Ph: (920) 731-8900	Keelyn Marie Wallenfang, APNP 1818 N Meade St, Appleton, WI 54911-3454 Ph: (920) 731-8900

Reviews and Comments

Nurse Practitioner Nurses in Appleton, WI

Ann M Hefter, AGACNP-BC, MSN, BSN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-731-8900
Dessia J Laxton, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-731-8900 Fax: 920-738-5369
Katie Geiser, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5045 W Grande Market Dr, Appleton, WI 54913 Phone: 920-886-9380
Ingrid K Simpson, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2400 E Capitol Dr, Appleton, WI 54911 Phone: 920-831-5050 Fax: 920-831-1867
Lisa Valiquette, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2500 E Capitol Dr, Appleton, WI 54911 Phone: 920-738-4600 Fax: 920-738-4792
Kimberly A Romenesko, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-735-7645 Fax: 920-735-7618
Steven R Hamel, APN FP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3925 N Gateway Dr, Appleton, WI 54913 Phone: 920-830-6877

Keelyn Marie Wallenfang, APNP - Medicare Nurse Practitioner in Appleton, WI