Individual provider Active NPI

William James Bjerregaard, M.D.

  • Psychiatry Physician
  • Racine, WI
National Provider Identifier
1043207806
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
27927-020 Issued in WI
Practice address
1244 Wisconsin Ave
Suite 303
Racine, WI 53403-1987
Phone
(262) 635-5520
Fax
(262) 635-5530
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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 27927-020 WI Primary

Addresses

Primary practice location

1244 Wisconsin Ave
Suite 303
Racine, WI 53403-1987

Mailing address

8700 Durand Ave
Ste 600
Sturtevant, WI 53177-2096
Phone (262) 635-5520

Other identifiers 1

IdentifierTypeStateIssuer
30780400MedicaidWI

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
I20101020000412 WI Practitioner - Psychiatry 3375549892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Wisconsin School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatric Services of Racine LLPGroup PAC ID 1658377148, 4 clinicians

Practice addresses (Care Compare)

8700 Durand Ave
Suite 600
Sturtevant, WI 53177-2096
Phone (262) 635-5520

Hospital & facility affiliations

  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27927-020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Services of Racine, LLP CurrentSince Jul 1, 1992 Accepting new patients

Locations

1244 Wisconsin Ave
Ste 303
Racine, WI 53403
Phone (262) 635-5520

8700 Durand Ave
Ste 600
Sturtevant, WI 53177
Phone (262) 635-5520

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1043207806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 DURAND AVE",
            "address_2": "STE 600",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531772096",
            "telephone_number": "262-635-5520",
            "fax_number": "262-635-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 WISCONSIN AVE",
            "address_2": "SUITE 303",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031987",
            "telephone_number": "262-635-5520",
            "fax_number": "262-635-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJERREGAARD",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "27927-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30780400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.