Individual provider Active NPI

Bernadette Demuri, M.D.

  • Psychiatry Physician
  • Wauwatosa, WI
National Provider Identifier
1003831959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25940 Issued in WI
Practice address
2600 N Mayfair Rd
Suite #305
Wauwatosa, WI 53226-1309
Phone
(414) 257-0233
Fax
(414) 257-3588
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25940 WI Primary

Addresses

Primary practice location

2600 N Mayfair Rd
Suite #305
Wauwatosa, WI 53226-1309

Mailing address

2600 N Mayfair Rd
Suite #305
Wauwatosa, WI 53226-1309
Phone (414) 257-0233

Other identifiers 1

IdentifierTypeStateIssuer
31714700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040114000360 WI Practitioner - Psychiatry 0143121103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Wisconsin School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Mental Health Consultants IncGroup PAC ID 5597665026, 8 clinicians

Practice addresses (Care Compare)

2600 N Mayfair Rd
Suite 305
Wauwatosa, WI 53226-1303
Phone (414) 257-0233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25940WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Mental Health Consultants Inc Psychiatry CurrentSince Oct 31, 2003 Accepting new patients

Locations

2600 N Mayfair Rd
Ste 305
Wauwatosa, WI 53226
Phone (414) 257-0233

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003831959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "SUITE #305",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-257-0233",
            "fax_number": "414-257-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "SUITE #305",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-257-0233",
            "fax_number": "414-257-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMURI",
        "first_name": "BERNADETTE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "25940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31714700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.