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PAUL ANTONISSEN APNP
NPI 1174096747
Nurse Practitioner - Family in De Pere, WI

Active since January 07, 2019PECOS Enrolled
3957 GARRETT ST, DE PERE, WI 54115(920) 471-3729 Get Directions Write a Review

NPPES record last updated: January 7, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Paul Antonissen Apnp NPPES

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

PAUL ANTONISSEN APNP (NPI 1174096747) is an individual family provider in De Pere, Wisconsin, licensed in Wisconsin (8973-33) and active in the NPI registry since January 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174096747
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NamePAUL ANTONISSENCredential: APNP
Location Address3957 GARRETT STDe Pere, WI 54115-1655
Mailing Address3957 Garrett StDe Pere, WI 54115-1655 · (920) 471-3729
Phone(920) 471-3729
Sole ProprietorNo
Enumeration DateJanuary 7, 2019
✔ NPI 1174096747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in WI · 8973-33
3957 GARRETT ST, De Pere, WI 54115
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paul Antonissen Apnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54115 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.

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 Paul Antonissen's NPI number?

The NPI number for Paul Antonissen is 1174096747. It was assigned to this individual provider in the NPPES registry on January 7, 2019.

Where is Paul Antonissen located?

Paul Antonissen practices at 3957 Garrett St, De Pere, WI 54115. The listed phone number is (920) 471-3729.

What is Paul Antonissen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Paul Antonissen enrolled in Medicare?

Yes. Paul Antonissen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Paul Antonissen was last updated on January 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.