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

Q: 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.

Q: What is Brooke Wangen'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 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.

Active since May 05, 2021PECOS EnrolledAccepts Medicare Assignment

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: August 02, 2026.

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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 and is a graduate of Other (2020).

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

Medical School CMSOtherGraduated 2020

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

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Other Names 1

Former Name (1)Brooke Marie Puccetti

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

Brooke Marie Wangen Aprn 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 ID1850793704

PECOS Enrollment IDI20210714002564

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 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.

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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