DORTHIA D CAMERON (NP) – Primary Care Nurse Practitioner, NPI 1669838496
Primary Care Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
6,033 NURSE PRACTITIONER in WI
Provider Addresses for DORTHIA D CAMERON (NP)
10400 75th St
Kenosha, WI 531427884
Phone: (262) 948-7000
Fax: (414) 385-4436
Type: Location
2514 S 102nd St Ste 160
West Allis, WI 532272142
Phone: (414) 255-0300
Fax: (414) 543-9601
Type: Location
530 NE GLEN OAK AVE
PEORIA, IL 616370001
Phone: (309) 624-8820
Fax: (309) 624-8820
Type: Mailing
South 102nd Street, West Allis, Milwaukee County, Wisconsin, 53214, United States
WEST ALLIS, WI 532272142
Phone: (414) 255-0300
Type: Mailing
3301 W FOREST HOME AVE
MILWAUKEE, WI 532152843
Phone: (262) 948-7000
Fax: (414) 385-4436
Type: Mailing
10400 75TH ST
KENOSHA, WI 531427884
Phone: (262) 948-7000
Fax: (414) 385-4436
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-04-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20160309000814 | I | Nurse Practitioner | WI | TBD |
| I20250414003245 | I | Nurse Practitioner | IL | 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 53142)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| - | TN | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Physician Assistant | MO | |
| - | IL |
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