TRACY DERKSEN APNP
NPI 1497304612
Nurse Practitioner - Family in Kewaskum, WI

Active since September 10, 2019PECOS EnrolledAccepts Medicare Assignment
1701 FOND DU LAC AVE, KEWASKUM, WI 53040(262) 626-4616 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 2, 2025, Feb 17, 2021, Sep 10, 2019 (3 updates tracked since 2019).

About Tracy Derksen Apnp NPPES

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

TRACY DERKSEN APNP (NPI 1497304612) is an individual family provider in Kewaskum, Wisconsin, licensed in Wisconsin (9480-33) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS, is affiliated with St Josephs Community Hospital West Bend, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1497304612
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTRACY DERKSENCredential: APNP
Location Address1701 FOND DU LAC AVEKewaskum, WI 53040-9129
Mailing Address1701 Fond Du Lac AveKewaskum, WI 53040-9129 · (262) 626-4616 · Fax (262) 626-4072
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateSeptember 10, 2019
Last NPPES UpdateSeptember 2, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2025
NPI 1497304612 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 · 9480-33
1701 FOND DU LAC AVE, Kewaskum, WI 53040

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted 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

Tracy Derksen Apnp 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 ID1951733930
PECOS Enrollment IDI20191112003655
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
127 services86 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
84 services56 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
44 services44 patients

Hospital Affiliations CMS Care Compare

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

St Josephs Community Hospital West Bend

Acute Care Hospitals · West Bend, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520063
Location3200 Pleasant Valley RoadWest Bend, WI 53095 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53040 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 10

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

Internal Medicine
1701 FOND DU LAC AVE
KEWASKUM, WI 53040
Family Medicine
1701 FOND DU LAC AVE
KEWASKUM, WI 53040
Physical Therapist
1701 FOND DU LAC AVE
KEWASKUM, WI 53040
Family Medicine
1701 FOND DU LAC AVE
KEWASKUM, WI 53040
Nurse Practitioner (Family)
1701 FOND DU LAC AVE
KEWASKUM, WI 53040
Internal Medicine
1701 FOND DU LAC AVE
KEWASKUM, WI 53040
Nurse Practitioner (Family)
1701 FOND DU LAC AVE
KEWASKUM, WI 53040
Family Medicine
1701 FOND DU LAC AVE
KEWASKUM, WI 53040

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 Tracy Derksen's NPI number?

The NPI number for Tracy Derksen is 1497304612. It was assigned to this individual provider in the NPPES registry on September 10, 2019.

Where is Tracy Derksen located?

Tracy Derksen practices at 1701 Fond Du Lac Ave, Kewaskum, WI 53040. The listed phone number is (262) 626-4616.

What is Tracy Derksen's specialty?

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

Is Tracy Derksen enrolled in Medicare?

Yes. Tracy Derksen 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 Tracy Derksen accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Tracy Derksen 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 Tracy Derksen affiliated with any hospitals?

According to CMS data, Tracy Derksen is affiliated with St Josephs Community Hospital West Bend.

When was this NPI record last updated?

The NPPES record for Tracy Derksen was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.