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KEISHA VICKMAN
NPI 1114526530
Nurse Practitioner in Green Bay, WI

Active since October 19, 2020PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
835 S VAN BUREN ST, GREEN BAY, WI 54301(920) 433-0111 Get Directions Write a Review

NPPES record last updated: October 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Keisha Vickman NPPES

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

KEISHA VICKMAN (NPI 1114526530) is an individual nurse practitioner in Green Bay, Wisconsin, licensed in Wisconsin (10477) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1114526530
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKEISHA VICKMAN
Location Address835 S VAN BUREN STGreen Bay, WI 54301-3526
Mailing Address835 S Van Buren StGreen Bay, WI 54301-3526 · (920) 433-0111
Phone(920) 433-0111
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateOctober 19, 2020
NPPES CertifiedSeptember 29, 2020
✔ NPI 1114526530 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 · 10477
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.
835 S VAN BUREN ST, Green Bay, WI 54301
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Keisha Vickman 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 ID7315359049
PECOS Enrollment IDI20201222000111
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.

Hospital Affiliations CMS Care Compare 2

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520097
Location1726 Shawano AveGreen Bay, WI 54303 · Brown County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54301 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

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.

MARY LYNN BARTEL MD
Pediatrics
835 S VAN BUREN ST, ROOM 1041
GREEN BAY, WI 54301
Brown County (920) 496-4700
DR. EKMINI WIJESINGHE MD
Hospitalist
835 S VAN BUREN ST, ST VINCENT HOSPITAL
GREEN BAY, WI 54301
Brown County (920) 272-1586
SALLY SCHLISE MD
Radiology (Radiation Oncology)
835 S VAN BUREN ST
GREEN BAY, WI 54301
Brown County (920) 433-8184
GREEN BAY ANESTHESIA ASSOC. SC
Anesthesiology
835 S VAN BUREN ST
GREEN BAY, WI 54301
Brown County (920) 433-0111
LEE JAMES KLEMENS MD
Internal Medicine
835 S VAN BUREN ST
GREEN BAY, WI 54301
Brown County (920) 496-4700
DR. REGINALD E JULIEN M.D.
Anesthesiology
835 S VAN BUREN ST
GREEN BAY, WI 54301
Brown County (920) 433-0111
ASHLEY M SPINDLER PA
Physician Assistant
835 S VAN BUREN ST
GREEN BAY, WI 54301
Brown County (920) 496-4700
DR. CHARLES F DAIS II M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
835 S VAN BUREN ST
GREEN BAY, WI 54301
Brown County (920) 433-8047

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keisha Vickman's NPI number?

The NPI number for Keisha Vickman is 1114526530. It was assigned to this individual provider in the NPPES registry on October 19, 2020.

Where is Keisha Vickman located?

Keisha Vickman practices at 835 S Van Buren St, Green Bay, WI 54301. The listed phone number is (920) 433-0111.

What is Keisha Vickman's specialty?

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

Is Keisha Vickman enrolled in Medicare?

Yes. Keisha Vickman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Keisha Vickman accept?

Health plans from Anthem Blue Cross and Blue Shield list Keisha Vickman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Keisha Vickman affiliated with any hospitals?

According to CMS data, Keisha Vickman is affiliated with St Vincent Hospital and St Mary's Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for Keisha Vickman was last updated on October 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.