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BROOKE MARIE WANGEN APRN
NPI 1770166894
Nurse Practitioner - Family in Springfield, IL

Active since May 05, 2021PECOS Enrolled
2532 FARRAGUT DR, SPRINGFIELD, IL 62704(217) 528-7541 Get Directions Write a Review

NPPES record last updated: May 5, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Brooke Marie Wangen Aprn NPPES

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

BROOKE MARIE WANGEN APRN (NPI 1770166894) is an individual family provider in Springfield, Illinois, licensed in Illinois (209022704) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770166894
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameBROOKE MARIE WANGENCredential: APRN
Location Address2532 FARRAGUT DRSpringfield, IL 62704-1433
Mailing Address1025 S 6th StSpringfield, IL 62703-2403 · (217) 528-7541
Phone(217) 528-7541
Sole ProprietorNo
Enumeration DateMay 5, 2021
NPPES CertifiedMay 5, 2021
✔ NPI 1770166894 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 IL · 209022704
2532 FARRAGUT DR, Springfield, IL 62704
Open in Google Maps ↗

Other Names 1

Former Name (1)Brooke Marie Puccetti

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brooke Marie Wangen Aprn 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 Reassignment

Medicare enrollment records show Brooke Wangen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Springfield Clinic, LLP
2.6 mi
Multi-Specialty
1025 S 6TH ST
Springfield, IL 62703
  • Reassigned Medicare billing, Illinois enrollment
  • 735 clinicians in this Medicare group
NPI 1780638478 (217) 528-7541

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 62704 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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 11

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

STEPHANIE E. WOJTOWICZ M.D.
Pediatrics
2532 FARRAGUT DR
SPRINGFIELD, IL 62704
Sangamon County (217) 787-9424
CLAUDINE GILLISON
Pediatrics
2532 FARRAGUT DR
SPRINGFIELD, IL 62704
Sangamon County (217) 528-7541
DR. SUSAN M. SOLER M.D.
Pediatrics
2532 FARRAGUT DR
SPRINGFIELD, IL 62704
Sangamon County (217) 787-9424
MISTY M. PHILLIPS M.D.
Pediatrics
2532 FARRAGUT DR
SPRINGFIELD, IL 62704
Sangamon County (217) 528-7541
SPRINGFIELD PEDIATRIC & ADOLESCENT CTR LAB
Clinical Medical Laboratory
2532 FARRAGUT DR
SPRINGFIELD, IL 62704
Sangamon County (217) 528-7541
GRETCHEN SUZANNE GIBBS M.D.
Pediatrics
2532 FARRAGUT DR
SPRINGFIELD, IL 62704
Sangamon County (217) 528-7541
LESLIE K FARRIS NP
Nurse Practitioner (Family)
2532 FARRAGUT DR
SPRINGFIELD, IL 62704
Sangamon County (217) 528-7541
MS. PENNY S. FRICKE R.N.,M.S.N.,CFNP
Clinical Nurse Specialist (Family Health)
2532 FARRAGUT DR
SPRINGFIELD, IL 62704
Sangamon County (217) 528-7541

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 Brooke Wangen's NPI number?

The NPI number for Brooke Wangen is 1770166894. It was assigned to this individual provider in the NPPES registry on May 5, 2021. The provider is also known as Brooke Marie Puccetti.

Where is Brooke Wangen located?

Brooke Wangen practices at 2532 Farragut Dr, Springfield, IL 62704. The listed phone number is (217) 528-7541.

What is Brooke Wangen's specialty?

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

Is Brooke Wangen enrolled in Medicare?

Yes. Brooke Wangen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Brooke Wangen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brooke Wangen reassigns Medicare benefits to Springfield Clinic, LLP (Springfield, IL). The 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 Brooke Wangen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Brooke Wangen was last updated on May 5, 2021. 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.