Individual provider Active NPI

Brian Weiland, PSY.D.

  • Clinical Psychologist
  • Weston, WI
National Provider Identifier
1063812246
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3570-57 Issued in WI
Practice address
2405 Schofield Ave Ste 220
Weston, WI 54476
Phone
(715) 842-9500
NPI assigned
Aug 25, 2014
Last updated
Aug 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3570-57 WI Primary

Addresses

Primary practice location

2405 Schofield Ave Ste 220
Weston, WI 54476

Mailing address

2405 Schofield Ave Ste 220
Weston, WI 54476-6422
Phone (715) 842-9500

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220125002089 WI Practitioner - Clinical Psychologist 1850722935 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1063812246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 SCHOFIELD AVE STE 220",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544766422",
            "telephone_number": "715-842-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 SCHOFIELD AVE STE 220",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "54476",
            "telephone_number": "715-842-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEILAND",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-25",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3570-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.