Michele A Cusatis, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

812-057 Issued in WI

Practice address

1501 Airport Rd
Waukesha, WI 53188-2461

Phone

(262) 548-7957

Fax

(262) 896-8046

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1114175262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 AIRPORT RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882461",
            "telephone_number": "262-548-7957",
            "fax_number": "262-896-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 AIRPORT RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882461",
            "telephone_number": "262-548-7957",
            "fax_number": "262-896-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSATIS",
        "first_name": "MICHELE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "812-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "084286001-WC",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39019400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.