HEIDI MARIE BRUCKERT
NPI 1831681402
Nurse Practitioner in Shawano, WI

Q: What is Heidi Bruckert's NPI number?

The NPI number for Heidi Bruckert is 1831681402. It was assigned to this individual provider in the NPPES registry on May 30, 2018.

Q: What is Heidi Bruckert'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 Heidi Bruckert was last updated on September 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 30, 2018PECOS EnrolledAccepts Medicare Assignment

1300 E GREEN BAY ST, SHAWANO, WI 54166(715) 201-0870 Get Directions Write a Review

NPPES record last updated: September 13, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Heidi Marie Bruckert NPPES

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

HEIDI MARIE BRUCKERT (NPI 1831681402) is an individual nurse practitioner in Shawano, Wisconsin, licensed in Wisconsin (8675-33) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1831681402

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameHEIDI MARIE BRUCKERT

Location Address1300 E GREEN BAY STShawano, WI 54166-2210

Mailing Address1300 E Green Bay StShawano, WI 54166-2210 · (920) 496-4700

Phone(715) 201-0870

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMay 30, 2018

Last NPPES UpdateSeptember 13, 2018

✔ NPI 1831681402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 8675-33

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.

Also ListedRegistered NurseTaxonomy 163W00000X · License 126356-30 (WI)

1300 E GREEN BAY ST, Shawano, WI 54166

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).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

Heidi Marie Bruckert 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 ID1658623459

PECOS Enrollment IDI20181005000518

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.

Hospital Affiliations CMS Care Compare

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54166 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 5

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

ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS

Clinic/Center (Mental Health (Including Community Mental Health Center))