THERESA J BASELEY NP
NPI 1043279805
Nurse Practitioner in Fond Du Lac, WI

Q: What is Theresa Baseley's NPI number?

The NPI number for Theresa Baseley is 1043279805. It was assigned to this individual provider in the NPPES registry on March 21, 2006.

Q: What is Theresa Baseley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Theresa Baseley was last updated on November 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 21, 2006PECOS EnrolledAccepts Medicare Assignment

210 WISCONSIN AMERICAN DR, FOND DU LAC, WI 54937(920) 907-7000(920) 907-7012 Get Directions Write a Review

NPPES record last updated: November 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 22, 2021, Feb 13, 2020 (2 updates tracked since 2020).

On this page

About Theresa J Baseley Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA J BASELEY NP (NPI 1043279805) is an individual nurse practitioner in Fond Du Lac, Wisconsin, licensed in Wisconsin (2688-033) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS, is affiliated with St. Agnes Hospital Hospice, and maintains a secondary practice location in North Fond Du Lac.

NPPES Registry Identity

NPI1043279805

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameTHERESA J BASELEYCredential: NP

Location Address210 WISCONSIN AMERICAN DRFond Du Lac, WI 54937-2999

Mailing Address3301 W Forest Home AveMilwaukee, WI 53215-2843 · (414) 389-2377

Phone(920) 907-7000

Fax(920) 907-7012

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateMarch 21, 2006

Last NPPES UpdateNovember 22, 20212 updates tracked since enumeration

NPPES CertifiedNovember 22, 2021

✔ NPI 1043279805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 2688-033

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

210 WISCONSIN AMERICAN DR, Fond Du Lac, WI 54937

Open in Google Maps ↗

Secondary Practice Location 1

Location 1723 Park Ridge LnNorth Fond Du Lac, WI 54937-1385 · Phone (920) 926-8600

Other Identifiers 1

Medicaid41272800WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theresa J Baseley Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395766703

PECOS Enrollment IDI20051213000793

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

91 services60 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

68 services68 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

42 services41 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

13 services13 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St. Agnes Hospital Hospice

Acute Care Hospitals · Fond Du Lac, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520088

Location430 E Division StFond Du Lac, WI 54935 · Fond Du Lac County

Emergency services Birthing friendly

Aurora Medical Ctr Oshkosh

Acute Care Hospitals · Oshkosh, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520198

Location855 N Westhaven DriveOshkosh, WI 54904 · Winnebago County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54937 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEANETTE ROEHL APNP FNP

Nurse Practitioner