Sally Andersen, FNP-BC, APNP is a medicare enrolled "Nurse Practitioner - Family" in Greenville, Wisconsin. She graduated from nursing school in 2012 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Ascension Medical Group-fox Valley Wisconsin Inc and her current practice location is
W6981 Parkview Dr, Greenville, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 882-2400.
Sally Andersen is licensed to practice in Wisconsin (license number 5543-33) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1366871634.
Provider's Profile
| Full Name | Sally Andersen |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 12 Years |
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| Location | W6981 Parkview Dr, Greenville, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Sally Andersen graduated from nursing school in 2012
NPI Data:
- NPI Number: 1366871634
- Provider Enumeration Date: 11/06/2013
- Last Update Date: 04/16/2021
Medicare PECOS Information:
- PECOS PAC ID: 1658685656
- Enrollment ID: I20150804006264
Medical Identifiers
Medical identifiers for Sally Andersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1366871634 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 5543-33 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Ascension Medical Group-fox Valley Wisconsin Inc | 0244142420 | 240 |
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. Sally Andersen allows following entities to bill medicare on her behalf.
| Entity Name | Ascension Medical Group-fox Valley Wisconsin Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730126392
PECOS PAC ID: 0244142420
Enrollment ID: O20031105000351 |
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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. Sally Andersen 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 |
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Sally Andersen, FNP-BC, APNP
W5505 Mile Long Dr,
Appleton, WI 54915-5220
Ph: (920) 851-6114 | Sally Andersen, FNP-BC, APNP
W6981 Parkview Dr,
Greenville, WI 54942-8034
Ph: (920) 882-2400 |
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