NPI registry status
Active
2026 NPPES data Pediatric Nurse Practitioner NPI 1255501987 NP
Verify on CMS → Andrea Hilgenberg, NP
Pediatric Nurse Practitioner in Appleton, Wisconsin.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 21,156 in Pediatric Nurse Practitioner, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
81
Medicare Part D claims · Pediatric Nurse Practitioner avg: 312
Generic prescribing
36%
generic claims · 64% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
80.5/100
▼ 3 pts below national avg 83.1 · Above neutral
Industry payments
$110.1
1 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Andrea Hilgenberg, NP reported a CMS MIPS final score of 80.5/100 - below the 83.1 national average - and filed 81 Medicare Part D claims in 2023.
- 80.5/100
- MIPS score · -3 vs avg
- 81
- Part D claims, 2023
- 36%
- generic prescribing
- $110.1
- industry payments (Sunshine Act)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Andrea Hilgenberg, NP's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
81 33rd percentile higher than 33% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Andrea Hilgenberg, NP sits
This provider among pediatric nurse practitioner peers
Across the 147 pediatric nurse practitioner providers who report both Medicare Part D prescribing and a MIPS quality score, Andrea Hilgenberg, NP writes more Part D claims than 50% of them and scores higher on MIPS quality than 41% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one pediatric nurse practitioner peer from a representative sample of 60; the gold marker is Andrea Hilgenberg, NP. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
What does the federal data show about Andrea Hilgenberg, NP?
Near national averagePrimary specialty
Pediatric Nurse Practitioner
Medicare Part D claims
81 74% vs specialty avg
MIPS final score
80.5/100 2.6 pts vs avg
Specialty distribution in Wisconsin
How Pediatric Nurse Practitioner compares to other specialties among Wisconsin providers
Medicare quality performance, MIPS
Andrea Hilgenberg, NP's 2023 MIPS final score plotted against the Pediatric Nurse Practitioner national average
- MIPS Final Score
- 80.5/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Pediatric Nurse Practitioner) - 80.5/100 vs national avg 83.1
How MIPS and board certification work
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Andrea Hilgenberg, NP appears in the CMS NPPES registry as a Pediatric Nurse Practitioner provider holding NP credentials at 2575 E EVERGREEN DRIVE, Appleton, WI, 54913, with a listed phone of (920) 969-5353. NPI 1255501987 was issued on 03/10/2008.
Medicare Part D records for calendar year 2023 show 81 prescription claims written by this provider, covering N/A Medicare beneficiaries and totaling roughly $153K in drug spend, split 64% brand-name and 36% generic by claim count. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 80.5/100 for the 2023 performance year (Quality 66.2, Cost 68.6), compared with the national average of 83.1.
Pediatric Nurse Practitioner is a mid-sized specialty nationwide, with 21,156 enrolled providers across 52 states and an average of 312 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline.
Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1255501987 |
|---|---|
| Specialty | Pediatric Nurse Practitioner |
| Credentials | NP |
| Gender | Female |
| NPI Issued | 03/10/2008 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
80.4671
Final Score
Avg: 83.1
66.2426
Quality
68.6477
Cost
100
Promoting Interoperability
Reporting: Group practice
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Andrea Hilgenberg, NP. Source: openpaymentsdata.cms.gov.
Total received
$110
Largest payer
AstraZeneca Pharmaceuticals LP
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
Brand vs generic prescribing mix · Brand-heavy
Andrea Hilgenberg, NP - brand share 64.0%
Pediatric Nurse Practitioner average
64% brand-name claims vs 36% generic, on 81 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
81
Total Claims
$153K
Total Drug Cost
N/A
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 102
- Total Day Supply
- 2,799
- Brand vs Generic
- 64% brand / 36% generic
- Brand Drug Cost
- $152K
- Generic Drug Cost
- $429
Patient Demographics
- Average Patient Age
- 51.4 years
- Avg HCC Risk Score
- 1.23
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Andrea Hilgenberg, NP prescribes most
Top Medicare Part D drugs by claim count, 2023
- Montelukast Sodium
Montelukast Sodium
14 claims
- Nucala
Nucala
12 claims
- Xolair
Xolair
11 claims
| Drug | Claims |
|---|---|
| Montelukast Sodium | 14 |
| Nucala Mepolizumab | 12 |
| Xolair Omalizumab | 11 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Pediatric Nurse Practitioner Overview
How Andrea Hilgenberg, NP fits within the Pediatric Nurse Practitioner landscape nationally.
21,156
Pediatric Nurse Practitioner Providers in US
52
States with Pediatric Nurse Practitioner
312
Avg Claims per Provider
Andrea Hilgenberg, NP's 81 claims are below the specialty average of 312.
Nearby Pediatric Nurse Practitioner Providers in Wisconsin
Other clinicians with the same primary specialty enrolled in Wisconsin, drawn from the same CMS NPPES roster as Hilgenberg.
Dr. Lynn Abad-Santos
APNP
Milwaukee, WI
Steven Abramowski
Milwaukee, WI
Dr. Jeannie Adams
CPNP
Watertown, WI
Dr. Jennifer Aiken
APNP
Milwaukee, WI
Dr. Kiera Akers
DNP, CPNP-PC, APNP
Wauwatosa, WI
Compare Pediatric Nurse Practitioner nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the Wisconsin medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Pediatric Nurse Practitioner peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Medical Specialties Explained
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Frequently Asked Questions
What is Andrea Hilgenberg, NP's specialty? ▼
Andrea Hilgenberg, NP specializes in Pediatric Nurse Practitioner and practices in Appleton, Wisconsin. Credentials: NP.
How much does Andrea Hilgenberg, NP prescribe under Medicare Part D? ▼
In 2023, Andrea Hilgenberg, NP wrote 81 Medicare Part D claims totaling $153K in drug costs for N/A beneficiaries.
What is Andrea Hilgenberg, NP's Medicare quality score? ▼
Andrea Hilgenberg, NP has a CMS MIPS Final Score of 80.5/100 (Quality: 66.2, Cost: 68.6). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Andrea Hilgenberg, NP located? ▼
Andrea Hilgenberg, NP is located at 2575 E EVERGREEN DRIVE, Appleton, WI, 54913. Phone: (920) 969-5353.
What is Andrea Hilgenberg, NP's NPI number? ▼
Andrea Hilgenberg, NP's National Provider Identifier (NPI) is 1255501987, issued on 03/10/2008.
Does Andrea Hilgenberg, NP prescribe more brand-name or generic drugs? ▼
Andrea Hilgenberg, NP's prescribing is 64% brand-name and 36% generic drugs by claim count, with $152K in brand drug costs.
How many Pediatric Nurse Practitioner providers are there in the US? ▼
There are 21,156 Pediatric Nurse Practitioner providers across 52 states in the US. The average Pediatric Nurse Practitioner provider writes 312 Medicare Part D claims per year.
What drugs does Andrea Hilgenberg, NP prescribe most often? ▼
Based on 2023 Medicare Part D data, Andrea Hilgenberg, NP's most frequently prescribed drugs include Montelukast Sodium, Nucala, Xolair. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Andrea Hilgenberg, NP accept Medicare? ▼
Andrea Hilgenberg, NP appears in CMS Medicare data with 81 Part D claims and N/A Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Andrea Hilgenberg, NP's credentials? ▼
Andrea Hilgenberg, NP's NPI is 1255501987 with credentials NP. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology
Compiled from official public sources by the PlainDoctor editorial team.
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.