BROOKE ELIZABETH KOTTKE – Family Nurse Practitioner, NPI 1104695246
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,066 NURSE PRACTITIONER in WI
Provider Addresses for BROOKE ELIZABETH KOTTKE
244266 GRASS CREEK LN
ATHENS, WI 544113400
Phone: (715) 573-9404
Type: Mailing
425 PINE RIDGE BLVD STE 200
WAUSAU, WI 544014123
Phone: (715) 847-2480
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $2,157.
Total Amount is formed as General ($2,157) + Research ($0) + Ownership ($0) = $2,157.
Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Pulmonx Corporation ($2,035).
Total Amount
$2,157
General + Research + Ownership
Payments
10
Total payment records
General Amount
$2,157
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-01-19
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240119002110 | I | Nurse Practitioner | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 54411)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NC | |
| - | IL | |
| Family Practice | WI | |
| - | MI | |
| Family Practice | WI | |
| Family Practice | WI | |
| - | WI | |
| Hospitalist, Internal Medicine | WI | |
| Certified Registered Nurse Anesthetist (Crna) | WI | |
| - | WI |
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