ELLEN JEAN ETTLIE APNP
NPI 1679128771
Nurse Practitioner in Janesville, WI

Q: What is Ellen Ettlie's NPI number?

The NPI number for Ellen Ettlie is 1679128771. It was assigned to this individual provider in the NPPES registry on August 6, 2019.

Q: What is Ellen Ettlie's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ellen Ettlie was last updated on November 11, 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.

Active since August 06, 2019PECOS EnrolledAccepts Medicare Assignment

3200 E RACINE ST, JANESVILLE, WI 53546(608) 371-8000(608) 371-8938 Get Directions Write a Review

NPPES record last updated: November 11, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 11, 2020, Aug 7, 2019 (2 updates tracked since 2019).

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About Ellen Jean Ettlie Apnp NPPES

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

ELLEN JEAN ETTLIE APNP (NPI 1679128771) is an individual nurse practitioner in Janesville, Wisconsin, licensed in Wisconsin (9343-33) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS, is affiliated with Mercy Health System Corp, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1679128771

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameELLEN JEAN ETTLIECredential: APNP

Location Address3200 E RACINE STJanesville, WI 53546-2343

Mailing Address1808 W Beltline HwyMadison, WI 53713-2334 · (608) 250-1497 · Fax (608) 250-1384

Phone(608) 371-8000

Fax(608) 371-8938

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateAugust 6, 2019

Last NPPES UpdateNovember 11, 20202 updates tracked since enumeration

NPPES CertifiedNovember 11, 2020

✔ NPI 1679128771 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 · 9343-33

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.

3200 E RACINE ST, Janesville, WI 53546

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Other Identifiers 1

Medicaid1679128771WI

Accepted Insurance

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

Ellen Jean Ettlie 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 ID4789911629

PECOS Enrollment IDI20190814003787

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 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.

94 services68 patients

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.

32 services29 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.

32 services32 patients

Hospital Affiliations CMS Care Compare

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

Mercy Health System Corp

Acute Care Hospitals · Janesville, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520066

Location1000 Mineral Point AveJanesville, WI 53548 · Rock County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53546 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 20

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

BRITTANY M. AUSTIN PA-C

Physician Assistant (Medical)