Individual provider Active NPI

Jonathan Deiches

  • Counselor
  • Madison, WI
National Provider Identifier
1104123959
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
625 W Washington Ave
Madison, WI 53703-2637
Phone
(608) 280-2700
NPI assigned
Feb 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

625 W Washington Ave
Madison, WI 53703-2637

Mailing address

625 W Washington Ave
Madison, WI 53703-2637

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdeiches42805@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20190103002816 WV Practitioner - Clinical Psychologist 4385980804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

156 Health Care LN
Martinsburg, WV 25401-4009
Phone (304) 596-5038

2004 Professional CT
Martinsburg, WV 25401-8808
Phone (304) 596-5780

2008 Professional CT
Martinsburg, WV 25401-8808
Phone 3042935033299

Hospital & facility affiliations

  • Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Physicians Inc CurrentSince Nov 1, 2018 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2023 Accepting new patients
University Healthcare Physicians, Inc. CurrentSince Nov 1, 2018 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2023 Accepting new patients

Locations

2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436

2004 Professional Ct
Martinsburg, WV 25401
Phone (304) 263-8964

1001 Sushruta Dr
Ste 100
Martinsburg, WV 25401
Phone (304) 596-5038

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Interoperability endpoints

  • Direct secure messaging: jdeiches42805@direct.wvuhsdirect.com

Organizations & group practices 4

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": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1104123959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032637",
            "telephone_number": "608-280-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEICHES",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-14",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdeiches42805@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2004 Professional Ct",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254018808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.