HEATHER J SORUM NP
NPI 1801850524
Nurse Practitioner - Adult Health in Waukesha, WI

Active since April 12, 2006PECOS EnrolledAccepts Medicare Assignment
721 AMERICAN AVE STE 205, PROHEALTH CARE DIABETES CENTER, WAUKESHA, WI 53188(262) 928-4695 Get Directions Write a Review

NPPES record last updated: November 8, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Heather J Sorum Np NPPES

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

HEATHER J SORUM NP (NPI 1801850524) is an individual adult health provider in Waukesha, Wisconsin, licensed in Wisconsin (2113) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1801850524
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameHEATHER J SORUMCredential: NP
Location Address721 AMERICAN AVE STE 205, PROHEALTH CARE DIABETES CENTERWaukesha, WI 53188-5071
Mailing Address721 American Ave Ste 205, Prohealth Care Diabetes CenterWaukesha, WI 53188-5071 · (262) 928-4695
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateApril 12, 2006
Last NPPES UpdateNovember 8, 2021
NPPES CertifiedNovember 8, 2021
NPI 1801850524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License Licensed in WI · 2113
Also ListedNurse PractitionerTaxonomy 363L00000X · License 2113 (WI), 136222 (WI)
721 AMERICAN AVE STE 205, Waukesha, WI 53188

Other Identifiers 1

Medicaid43979600WI

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

Heather J Sorum Np 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 ID9931357829
PECOS Enrollment IDI20120918000927
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 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.

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.
110 services94 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.
93 services81 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.
43 services43 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Oconomowoc Memorial Hospital

Acute Care Hospitals · Oconomowoc, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520062
Location791 E Summit AveOconomowoc, WI 53066 · Waukesha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53188 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 3

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

Nurse Practitioner (Adult Health)
721 AMERICAN AVE STE 205, PROHEALTH CARE DIABETES CENTER
WAUKESHA, WI 53188
Nurse Practitioner
721 AMERICAN AVE STE 205, PROHEALH CARE DIABETES CENTER
WAUKESHA, WI 53188
Nurse Practitioner (Adult Health)
721 AMERICAN AVE STE 205, PROHEALTH CARE MEDICAL ASSOCIATES INC.
WAUKEHSA, WI 53188

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 Heather Sorum's NPI number?

The NPI number for Heather Sorum is 1801850524. It was assigned to this individual provider in the NPPES registry on April 12, 2006.

Where is Heather Sorum located?

Heather Sorum practices at 721 American Ave Ste 205 Prohealth Care Diabetes Center, Waukesha, WI 53188. The listed phone number is (262) 928-4695.

What is Heather Sorum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Heather Sorum enrolled in Medicare?

Yes. Heather Sorum 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 Heather Sorum accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and UnitedHealthcare list Heather Sorum 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 Heather Sorum affiliated with any hospitals?

According to CMS data, Heather Sorum is affiliated with Waukesha Memorial Hospital and Oconomowoc Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Heather Sorum was last updated on November 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.