DORISSE MIREILLE NGUIMFACK (NP) – Family Nurse Practitioner, NPI 1922422963
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
6,033 NURSE PRACTITIONER in WI
Provider Addresses for DORISSE MIREILLE NGUIMFACK (NP)
4425 N PORT WASHINGTON RD
GLENDALE, WI 532121082
Phone: (414) 326-2218
Type: Mailing
2311 N PROSPECT AVE
MILWAUKEE, WI 532114445
Phone: (414) 319-3000
Fax: (414) 319-3033
Type: Location
PO BOX 4699
LAFAYETTE, IN 479034699
Phone: (765) 449-2732
Fax: (765) 449-1196
Type: Mailing
3360 N Watkins St
Memphis, TN 381276405
Phone: (901) 401-7150
Type: Location
1000 S Elmora Ave
Elizabeth, NJ 072023100
Phone: (908) 737-5703
Type: Location
1345 UNITY PL STE 355
LAFAYETTE, IN 479055761
Phone: (765) 807-7988
Fax: (765) 807-7989
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $468.
Total Amount is formed as General ($468) + Research ($0) + Ownership ($0) = $468.
Last reported payment date: 2024-09-17 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($127).
Total Amount
$468
General + Research + Ownership
Payments
5
Total payment records
General Amount
$468
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teva Pharmaceuticals USA, Inc. | $127 |
| Neurocrine BioSciences Inc. | $122 |
| Bayer Healthcare Pharmaceuticals Inc. | $121 |
| Kerecis Limited | $98 |
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: 2025-05-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 6 Medicare enrollment records; no due dates published yet.
Enrollment records
6
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 |
|---|---|---|---|---|
| I20150223001076 | I | Nurse Practitioner | WI | TBD |
| I20180105000200 | I | Nurse Practitioner | IN | TBD |
| I20250214000684 | I | Nurse Practitioner | CT | TBD |
| I20250217002802 | I | Nurse Practitioner | TN | TBD |
| I20250226002307 | I | Nurse Practitioner | NJ | TBD |
| I20250514000914 | I | Nurse Practitioner | PA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 60 | 43 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 58 | 58 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 26 | 26 | $0 |
| G0008 | Administration of influenza virus vaccine | 14 | 13 | $0 |
Insurance plans in this area (ZIP 53212)
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