MARY L THEISEN NP
NPI 1396248407
Nurse Practitioner - Family in Milwaukee, WI

Q: What is Mary Theisen's NPI number?

The NPI number for Mary Theisen is 1396248407. It was assigned to this individual provider in the NPPES registry on March 14, 2018.

Q: What is Mary Theisen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mary Theisen was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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 14, 2018PECOS Enrolled

11002 W PARK PL, MILWAUKEE, WI 53224(414) 365-8300 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 18, 2026, Aug 2, 2022, Apr 9, 2018 and 2 more (5 updates tracked since 2018).

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About Mary L Theisen Np NPPES

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

MARY L THEISEN NP (NPI 1396248407) is an individual family provider in Milwaukee, Wisconsin, licensed in Wisconsin (8349-33) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1396248407

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARY L THEISENCredential: NP

Location Address11002 W PARK PLMilwaukee, WI 53224-3615

Mailing Address11002 W Park PlMilwaukee, WI 53224-3615 · (414) 365-8300

Phone(414) 365-8300

Sole ProprietorNo

Enumeration DateMarch 14, 2018

Last NPPES UpdateMarch 18, 20265 updates tracked since enumeration

NPPES CertifiedMarch 18, 2026

✔ NPI 1396248407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in WI · 8349-33

Also ListedRegistered NurseTaxonomy 163W00000X · License 185282-30 (WI)

Also ListedNurse PractitionerTaxonomy 363L00000X · License 8349-33 (WI)

11002 W PARK PL, Milwaukee, WI 53224

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Secondary Practice Locations 5

Location 1112 E Drexel AveOak Creek, WI 53154-2123 · Phone (414) 365-8300

Location 23232 Pleasant Valley RdWest Bend, WI 53095-9274 · Phone (414) 365-8300

Location 38503 75th St Ste BKenosha, WI 53142-7620 · Phone (414) 365-8300

Location 4110 Lone Oak LnHartford, WI 53027-2600 · Phone (414) 365-8300

Location 513111 N Port Washington RdMequon, WI 53097-2416 · Phone (414) 365-8300

Other Identifiers 1

Medicaid1396248407WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary L Theisen Np 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 53224 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 5

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

ANGELA BRAGGS LPC-IT

Counselor (Mental Health)