HEATHER AVELLONE
NPI 1114499001
Nurse Practitioner - Family in Waukesha, WI

NPI Status: Active since December 18, 2018

Contact Information

725 AMERICAN AVE
WAUKESHA, WI
ZIP 53188
Phone: (262) 928-5400
Fax: (262) 928-6140

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  • Individual
  • Female
  • Nurse Practitioner
  • Family
  • Accepts Insurance
  • PECOS Enrolled

About HEATHER AVELLONE

This page provides the complete NPI Profile along with additional information for Heather Avellone, a provider established in Waukesha, Wisconsin with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1114499001 assigned on December 2018. The practitioner's primary taxonomy code is 363LF0000X with license number 8257 (WI). The provider is registered as an individual and her NPI record was last updated 8 years ago.

NPI
1114499001
Provider Name
HEATHER AVELLONE
Gender
Female
Entity Type
Individual
Location Address
725 AMERICAN AVE WAUKESHA, WI 53188
Location Phone
(262) 928-5400
Location Fax
(262) 928-6140
Mailing Address
PO BOX 708760 SANDY, UT 84070
Mailing Phone
(801) 352-9500
Mailing Fax
(262) 928-6140
Is Sole Proprietor?
No
Enumeration Date
12-18-2018
Last Update Date
12-18-2018
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A nurse practitioner (NP) like Heather Avellone is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
8257
License State
WI

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Heather Avellone is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 16 times for 11 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 12 times for 12 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 32 times for 32 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53188 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.92
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $20.73
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.41
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $23.85
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for HEATHER AVELLONE

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1114499001, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
1
Doubled → 2
Pos 4
4
Unchanged
Pos 5
4
Doubled → 8
Pos 6
9
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
0
Unchanged
Pos 9
0
Doubled → 0
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 4 → 8 9 → 18 → 9 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 2 + 4 + 8 + 9 + 1 + 8 + 0 + 0 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1114499001.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physical Therapist
725 AMERICAN AVE
WAUKESHA, WI 53188
Hospitalist
725 AMERICAN AVE, WAUKESHA MEMORIAL HOSPITAL-HOSPITALIST GROUP
WAUKESHA, WI 53188
Radiology (Vascular & Interventional Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Vascular & Interventional Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Neuroradiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Neuroradiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Body Imaging)
725 AMERICAN AVE
WAUKESHA, WI 53188
Radiology (Diagnostic Radiology)
725 AMERICAN AVE
WAUKESHA, WI 53188
Emergency Medicine
725 AMERICAN AVE, SUITE 5
WAUKESHA, WI 53188
Anesthesiology
725 AMERICAN AVE
WAUKESHA, WI 53188

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114499001, enumerated as an "individual" on December 18, 2018.

The provider is located at 725 AMERICAN AVE WAUKESHA, WI 53188 and the phone number is (262) 928-5400.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: CareSource (Common Ground Healthcare). Please consult your insurance carrier or call the provider to verify.