Individual provider Active NPI

Wess R Vogt, M.D.

  • Psychiatry Physician
  • Mequon, WI
National Provider Identifier
1023124708
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
15734-020 Issued in WI
Practice address
1035 W Glen Oaks LN
Suite 204
Mequon, WI 53092-3392
Phone
(262) 512-9400
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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 15734-020 WI Primary

Addresses

Primary practice location

1035 W Glen Oaks LN
Suite 204
Mequon, WI 53092-3392

Mailing address

PO Box 639
Cedarburg, WI 53012-0639
Phone (262) 512-9400

Other identifiers 2

IdentifierTypeStateIssuer
13585800MedicaidWI
31585800MedicaidWI

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
I20040317001474 WI Practitioner - PsychiatryPractitioner - Orthopedic Surgery 0143110783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Wisconsin, 1965
Medicare assignment
May accept Medicare assignment
Group practices
Affiliated Clinical Services IncGroup PAC ID 0244124899, 22 clinicians

Practice addresses (Care Compare)

111 E Washington St
West Bend, WI 53095-2571
Phone (262) 338-2717

423 E N Point Rd
Mequon, WI 53092-5824
Phone (262) 512-9400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15734-020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Psychiatric Services, LTD Psychiatry CurrentSince Jul 1, 1990 Accepting new patients
Affiliated Clinical Services Inc CurrentSince Feb 1, 2012 Accepting new patients
Lutheran Social Services of Wisconsin and Upper Michigan, Inc. Past Accepting new patients

Locations

1035 W Glen Oaks Ln
Ste 204
Mequon, WI 53092
Phone (262) 241-1515

111 E Washington St
West Bend, WI 53095
Phone (262) 338-2717

Organizations & group practices 3

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1023124708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530120639",
            "telephone_number": "262-512-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 W GLEN OAKS LN",
            "address_2": "SUITE 204",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923392",
            "telephone_number": "262-512-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGT",
        "first_name": "WESS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "15734-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13585800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31585800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.