PAIGE BROCKDORF DNP, APRN, FNP-BC
NPI 1790457638
Nurse Practitioner - Family in Appleton, WI

Q: What is Paige Brockdorf's NPI number?

The NPI number for Paige Brockdorf is 1790457638. It was assigned to this individual provider in the NPPES registry on September 29, 2021. The provider is also known as Paige Domurat.

Q: What is Paige Brockdorf'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 Paige Brockdorf was last updated on March 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 September 29, 2021PECOS EnrolledAccepts Medicare Assignment

5320 W MICHAELS DR, APPLETON, WI 54913(920) 882-8200(920) 882-8210 Get Directions Write a Review

NPPES record last updated: March 3, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 3, 2025, Aug 6, 2022, Sep 29, 2021 (3 updates tracked since 2021).

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About Paige Brockdorf Dnp, Aprn, Fnp-bc NPPES

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

PAIGE BROCKDORF DNP, APRN, FNP-BC (NPI 1790457638) is an individual family provider in Appleton, Wisconsin, licensed in Wisconsin (11108-33) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1790457638

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NamePAIGE BROCKDORFCredential: DNP, APRN, FNP-BC

Location Address5320 W MICHAELS DRAppleton, WI 54913-8446

Mailing Address5320 W Michaels DrAppleton, WI 54913-8446 · (920) 882-8200

Phone(920) 882-8200

Fax(920) 882-8210

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateSeptember 29, 2021

Last NPPES UpdateMarch 3, 20253 updates tracked since enumeration

NPPES CertifiedMarch 3, 2025

✔ NPI 1790457638 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 · 11108-33

5320 W MICHAELS DR, Appleton, WI 54913

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Other Names 1

Former Name (1)Paige Domurat

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Paige Brockdorf Dnp, Aprn, Fnp-bc 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 ID6305235243

PECOS Enrollment IDI20211115000635

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 Reassignments

Medicare enrollment records show Paige Brockdorf reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Neurospine Center Of Wisconsin, S.C.

Same address

Neurological Surgery

5320 MICHAELS DR
Appleton, WI 54913

Reassigned Medicare billing, Wisconsin enrollment
17 clinicians in this Medicare group

NPI 1053321620 (920) 882-8200

New Medical Center, S.C.

45 mi

General Practice

160 GATEWAY DR, STE A
Waupun, WI 53963

Reassigned Medicare billing, Wisconsin enrollment
6 clinicians in this Medicare group

NPI 1093368607 (920) 324-9899

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.

Injection of trigger points, 3 or more muscles 20553

Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.

80 services32 patients

Injection of trigger points, 1-2 muscles 20552

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.

19 services14 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.

17 services15 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520045

Location130 2nd StNeenah, WI 54956 · Winnebago County

Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520160

Location1818 N Meade StAppleton, WI 54911 · Outagamie County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54913 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 19

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

JAMI ELIZABETH HELLMER NP

Nurse Practitioner