Ms Terry A Kollenbroich, CPNP in Waterford, WI

Ms Terry A Kollenbroich, CPNP is a medicare enrolled "Nurse Practitioner" in Waterford, Wisconsin. Her current practice location is 818 Forest Ln, Waterford, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 514-3700.

Ms Terry A Kollenbroich is licensed to practice in Wisconsin (license number 2373) 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 1235180076.

Contact Information

	Ms Terry A Kollenbroich, CPNP
	818 Forest Ln, Waterford, WI 53185-4585
	(262) 514-3700
	(262) 514-3867

Map and Direction

Provider's Profile

Full Name	Ms Terry A Kollenbroich
Gender	Female
Speciality	Nurse Practitioner
Location	818 Forest Ln, Waterford, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235180076
Provider Enumeration Date: 05/15/2006
Last Update Date: 10/21/2024

Medicare PECOS Information:

PECOS PAC ID: 9436051851
Enrollment ID: I20040124000268

Medical Identifiers

Medical identifiers for Ms Terry A Kollenbroich such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235180076	NPI	-	NPPES
39847700	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	2373 (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. Ms Terry A Kollenbroich allows following entities to bill medicare on her behalf.

Entity Name	Aurora Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725

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. Ms Terry A Kollenbroich 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
Ms Terry A Kollenbroich, CPNP Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-6250	Ms Terry A Kollenbroich, CPNP 818 Forest Ln, Waterford, WI 53185-4585 Ph: (262) 514-3700

Reviews and Comments

Nurse Practitioner Nurses in Waterford, WI

Cathy Jo Duchow-cross, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7914 Foxwater Blvd, Waterford, WI 53185 Phone: 414-531-2228
Kimberley G Van Buren, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 818 Forrest Dr, Waterford, WI 53185 Phone: 262-514-3700
Melissa A Kersten, FNP, RN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 818 Forest Ln, Waterford, WI 53185 Phone: 262-514-8199 Fax: 608-741-3838
Mrs. Beth A Weidman, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 818 Forest Ln, Waterford, WI 53185 Phone: 262-514-3700
Ms. Kim T Duczak, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 818 Forrest Ln, Waterford, WI 53185 Phone: 262-514-3700 Fax: 262-514-3865
Shelley Flasch, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 818 Forest Ln, Waterford, WI 53185 Phone: 262-148-1995

Ms Terry A Kollenbroich, CPNP - Medicare Nurse Practitioner in Waterford, WI