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CARRIE HECOX RN,MSN,CPNP
NPI 1194245886
Nurse Practitioner - Pediatrics in Milwaukee, WI

Active since June 22, 2017PECOS Enrolled
80.46/100
CMS Quality Rating
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226(414) 266-3360(414) 266-5363 Get Directions Write a Review

NPPES record last updated: September 22, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 22, 2017, Sep 12, 2017, Jun 22, 2017 (3 updates tracked since 2017).

About Carrie Hecox Rn,msn,cpnp NPPES

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

CARRIE HECOX RN,MSN,CPNP (NPI 1194245886) is an individual pediatrics provider in Milwaukee, Wisconsin, licensed in Wisconsin (7978-33) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194245886
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameCARRIE HECOXCredential: RN,MSN,CPNP
Location Address9000 W WISCONSIN AVEMilwaukee, WI 53226-4874
Mailing Address9000 W Wisconsin AvenueMilwaukee, WI 53226-4874 · (414) 266-3360 · Fax (414) 266-3563
Phone(414) 266-3360
Fax(414) 266-5363
Sole ProprietorNo
Enumeration DateJune 22, 2017
Last NPPES UpdateSeptember 22, 20173 updates tracked since enumeration
✔ NPI 1194245886 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in WI · 7978-33
Also ListedRegistered Nurse · PediatricsTaxonomy 163WP0200X · License 159164-30 (WI), 041311136 (IL)
9000 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Other Identifiers 1

Medicaid1194245886WI

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carrie Hecox Rn,msn,cpnp 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Carrie Hecox reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Children's Specialty Group, Inc.
0.1 mi
Pediatrics
9000 W WISCONSIN AVE
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Childrens Specialty Group Inc
  • 424 clinicians in this Medicare group
NPI 1942970405 (414) 266-2000
The Medical College Of Wisconsin, Inc.
0.2 mi
Internal Medicine
8701 WATERTOWN PLANK RD
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • 3,983 clinicians in this Medicare group
NPI 1699720086 (414) 955-7101

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.24
Promoting Interoperability100
Improvement Activities40
Cost68.64

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.

MS. LESLIE L. TALBERT NP
Nurse Practitioner (Pediatrics)
9000 W WISCONSIN AVE, PEDIATRIC CRITICAL CARE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-3360
SARAH MARIE RUMLER DO
Pediatrics (Pediatric Hematology-Oncology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-4170
ALISON COREN
Pediatrics (Pediatric Endocrinology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6750
BRANDON PALMER M.D.
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 337-7050
AIDAN JAMES REID DO
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6800
KYNDAL LYN HETTICH RD, CSP, CD
Dietitian, Registered
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-5938
CARISA MARIE DIMATTINA LCSW
Social Worker (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 581-4004
BREYA LOGAN WHITEFIELD PHD
Psychologist (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-2000

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 Carrie Hecox's NPI number?

The NPI number for Carrie Hecox is 1194245886. It was assigned to this individual provider in the NPPES registry on June 22, 2017.

Where is Carrie Hecox located?

Carrie Hecox practices at 9000 W Wisconsin Ave, Milwaukee, WI 53226. The listed phone number is (414) 266-3360.

What is Carrie Hecox's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Carrie Hecox enrolled in Medicare?

Yes. Carrie Hecox is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Carrie Hecox's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carrie Hecox reassigns Medicare benefits to 2 organizations: Children's Specialty Group, Inc. (Milwaukee, WI) and The Medical College Of Wisconsin, Inc. (Milwaukee, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carrie Hecox's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carrie Hecox accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and Network Health list Carrie Hecox 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.

When was this NPI record last updated?

The NPPES record for Carrie Hecox was last updated on September 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.