Individual provider Active NPI

Robert Henry Husemann Jr., PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dubuque, IA
National Provider Identifier
1013639749
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G171205 Issued in IA
Practice address
1598 McPoland Ave
Dubuque, IA 52001-5521
Phone
(563) 580-1800
NPI assigned
Sep 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G171205 IA Primary

Addresses

Primary practice location

1598 McPoland Ave
Dubuque, IA 52001-5521

Mailing address

3423 Crescent RDG
Dubuque, IA 52003-5234
Phone (563) 580-1800

Other identifiers 1

IdentifierTypeStateIssuer
884185848OtherIASTATE OF IOWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230403000127 IA Practitioner - Nurse Practitioner 9335514512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bridgeview Community Mental Health CenterGroup PAC ID 8325058308, 6 clinicians

Practice addresses (Care Compare)

1320 19TH Ave NW
Clinton, IA 52732-2752
Phone (563) 243-5633

1598 McPoland Ave
Dubuque, IA 52001-5521
Phone (563) 495-5448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G171205IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New View Psychiatry Psychiatric/Mental Health CurrentSince Nov 5, 2024 Accepting new patients
Bridgeview Community Mental Health Center Psychiatric/Mental Health CurrentSince Mar 23, 2023 Accepting new patients

Locations

849 13th Ave N
Clinton, IA 52732
Phone (563) 242-1521

1320 19th Ave NW
Clinton, IA 52732
Phone (563) 243-5633

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1013639749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 CRESCENT RDG",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520035234",
            "telephone_number": "563-580-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1598 MCPOLAND AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520015521",
            "telephone_number": "563-580-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSEMANN",
        "first_name": "ROBERT",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G171205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IOWA",
            "identifier": "884185848",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.