Stacy L Boden, NP - Medicare Nurse Practitioner in West Bend, WI

Stacy L Boden, NP is a medicare enrolled "Nurse Practitioner - Pediatrics" in West Bend, Wisconsin. Her current practice location is 3200 Pleasant Valley Rd, West Bend, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 334-3451.

Stacy L Boden is licensed to practice in Wisconsin (license number 144166) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124250063.

Contact Information

Stacy L Boden, NP
3200 Pleasant Valley Rd,
West Bend, WI 53095-9274
(262) 334-3451
(262) 306-2964



Provider's Profile

Full NameStacy L Boden
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location3200 Pleasant Valley Rd, West Bend, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124250063
  • Provider Enumeration Date: 08/11/2009
  • Last Update Date: 08/11/2009
  Medicare PECOS Information:
  • PECOS PAC ID: 7012053515
  • Enrollment ID: I20091014000614

Medical Identifiers

Medical identifiers for Stacy L Boden such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124250063NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics 144166 (Wisconsin)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Stacy L Boden allows following entities to bill medicare on her behalf.
Entity NameFroedtert &the Medical College Of Wisconsin Community Physicians Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568787448
PECOS PAC ID: 3678760063
Enrollment ID: O20101210000699

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacy L Boden is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Stacy L Boden, NP
1700 W Paradise Dr,
West Bend, WI 53095-9795

Ph: (262) 334-3451
Stacy L Boden, NP
3200 Pleasant Valley Rd,
West Bend, WI 53095-9274

Ph: (262) 334-3451

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Nurse Practitioner Nurses in West Bend, WI

Alyssa Sekadlo,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 111 E Washington St, West Bend, WI 53095
Phone: 262-338-2717    Fax: 262-338-9767
Katelyn Steger, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1700 W Paradise Dr, West Bend, WI 53095
Phone: 262-334-3451    
Samantha Beth Hellman, AGPCNP-BC, APNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095
Phone: 262-836-7300    Fax: 262-836-7301
Jennifer Nicole Thomson, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1700 W Paradise Dr, West Bend, WI 53095
Phone: 262-334-3451    
Dr. Shanice S Kukuck, APNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1700 Paradise Dr, West Bend, WI 53095
Phone: 262-334-3451    
Casey L Nolan, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 3200 Pleasant Valley Rd, Internal Medicine, West Bend, WI 53095
Phone: 262-836-7300    Fax: 262-836-7301

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