CMS-1500 Box 24J / 33a • NPI
1144570433
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP0200X (CMS 50)
Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)
Box 32 Service Location & ZIP+4
10303 N PORT WASHINGTON RD, SUITE 203, MEQUON, WI, 53092-5760
✓ 9-Digit EDI 837 ZIP+4 (53092-5760)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1144570433 (NINA SEBASTIAN BREDEHORN, MSN, APNP, CPNP, PMH) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1144570433 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | NINA SEBASTIAN BREDEHORN, MSN, APNP, CPNP, PMH |
| Plain-English Specialty | Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: 363LP0200X (Nurse Practitioner, Pediatrics) |
| Certifying / Licensing Body | American Board of Pediatrics (ABP) |
| Practice Location Address | 10303 N PORT WASHINGTON RD, SUITE 203, MEQUON, WI, 53092-5760 |
| Practice Telephone / Fax | Tel: (262) 241-5955 | Fax: (262) 241-5926 |
| Administrative Mailing Address | 124 E HARRISON ST, COLUMBUS, WI, 53925-1510 |
| Enumeration & Last Sync | Enumerated: 2012-09-13 | CMS Record Updated: 2018-03-17 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP0200X)
What Does Taxonomy Code 363LP0200X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP0200X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (NINA SEBASTIAN BREDEHORN, MSN, APNP, CPNP, PMH)
Typical CPT / Diagnostic Procedures:- Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
- Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
- Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
- Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
- Pediatric Asthma Nebulization & Spirometry Evaluation
- Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
- WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
- Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
- Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
163WP0808X — Registered Nurse, Psych/Mental HealthPlain English: Licensed & Credentialed Registered Nurse, Psych/Mental Health | State: WI | License: 170295-30 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: WI | License: 4971-33 | Primary: Secondary |
363LP0200X — Nurse Practitioner, PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: WI | License: 4971-33 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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