Individual provider Active NPI

Scott C Stauter

  • Clinical Psychologist
  • Madison, WI
National Provider Identifier
1164288916
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5587-57 Issued in WI
Practice address
700 Ray O Vac Dr Ste 103
Madison, WI 53711-2468
Phone
(608) 444-4856
NPI assigned
Feb 27, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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 5587-57 WI Primary

Addresses

Primary practice location

700 Ray O Vac Dr Ste 103
Madison, WI 53711-2468

Mailing address

2145 Fox Ave
Madison, WI 53711-1920
Phone (608) 444-4856

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
I20251126000290 WI Practitioner - Clinical Social Worker 9830681865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regent Mental Health Group SCGroup PAC ID 5294053112, 17 clinicians

Practice addresses (Care Compare)

700 Ray O Vac Dr
Suite 103
Madison, WI 53711-2468
Phone (608) 238-5826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
134756-121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Regent Mental Health Group SC CurrentSince Oct 20, 2025 Accepting new patients

Locations

700 Ray O Vac Dr
Ste 103
Madison, WI 53711
Phone (608) 238-5826

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.

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1164288916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 FOX AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111920",
            "telephone_number": "608-444-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAY O VAC DR STE 103",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112468",
            "telephone_number": "608-444-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUTER",
        "first_name": "SCOTT",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-27",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "5587-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.