NPIMap

Organization Active NPI

Medical Psychology Associates, Inc.

  • Adult Mental Health Clinic/Center
  • Glendale, WI
National Provider Identifier
1043307598
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
2653-057 Issued in WI
Legal business name
MEDICAL PSYCHOLOGY ASSOCIATES, INC.
Practice address
6110 N Port Washington Rd
Glendale, WI 53217-4308
Phone
(414) 962-1000
Fax
(414) 963-6866
NPI assigned
Oct 6, 2006
Last updated
May 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Authorized official

Name
Dr. Kelly E Smerz, PH.D.NPI 1477615631
Title
Director/President
Phone
(414) 962-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 2653-057 WI Primary

Addresses

Primary practice location

6110 N Port Washington Rd
Glendale, WI 53217-4308

Mailing address

6110 N Port Washington Rd
Glendale, WI 53217-4308
Phone (414) 962-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040417000024 WI Part B Supplier - Clinic/Group Practice 9133114333 Receives reassigned benefits from 11 practitioners
Practice locations: Glendale, WI; Greenfield, WI

National Provider Directory

National Provider Directory
Tax ID family
Medical Psychology Asso2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5225 N Ironwood Rd
Ste 212
Glendale, WI 53217
Phone (414) 350-2317

6520 W Layton Ave
Ste 206
Greenfield, WI 53220
Phone (414) 962-1000

2900 W Oklahoma Ave
Ste 516
Milwaukee, WI 53215

2900 W Oklahoma Ave
Ste S516
Milwaukee, WI 53215
Phone (414) 649-6235

2901 W Kinnickinnic River Pkwy
Ste 516
Milwaukee, WI 53215
Phone (414) 385-3084

8340 W Fond du Lac Ave
Milwaukee, WI 53218

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367884800000",
    "number": "1043307598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174308",
            "telephone_number": "414-962-1000",
            "fax_number": "414-963-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174308",
            "telephone_number": "414-962-1000",
            "fax_number": "414-963-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PSYCHOLOGY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2013-05-07",
        "status": "A",
        "authorized_official_last_name": "SMERZ",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "414-962-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WI",
            "license": "2653-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.