CMS-1500 Box 24J / 33a • NPI
1578023438
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
107 OAK ST W STE 100, FREDERIC, WI, 54837-9049
✓ 9-Digit EDI 837 ZIP+4 (54837-9049)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1578023438 (KACI LEE TOLZMAN, NP) 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 | 1578023438 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KACI LEE TOLZMAN, NP |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 107 OAK ST W STE 100, FREDERIC, WI, 54837-9049 |
| Practice Telephone / Fax | Tel: (715) 318-0916 |
| Administrative Mailing Address | 2310 280TH ST, CLEAR LAKE, WI, 54005-4417 |
| Enumeration & Last Sync | Enumerated: 2019-03-25 | CMS Record Updated: 2025-05-27 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KACI LEE TOLZMAN, NP)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: WI | License: 16639-33 | Primary: Secondary |
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: WI | License: 16639-33 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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