Individual provider Active NPI

Mark H Rossing, MD

  • Psychiatry Physician
  • Oconomowoc, WI
National Provider Identifier
1184659591
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
33425 Issued in WI
Practice address
888 Thackeray Trail
#211
Oconomowoc, WI 53066-4641
Phone
(262) 567-1122
Fax
(262) 567-1481
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 33425 WI Primary

Addresses

Primary practice location

888 Thackeray Trail
#211
Oconomowoc, WI 53066-4641

Mailing address

888 Thackeray Trail
#211
Oconomowoc, WI 53066-4641
Phone (262) 567-1122

Other identifiers 1

IdentifierTypeStateIssuer
31875700MedicaidWI

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040127000841 WI Practitioner - Psychiatry 2860395084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Wisconsin, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Rogers Memorial Hospital IncorporatedGroup PAC ID 3476455809, 46 clinicians

Practice addresses (Care Compare)

34700 Valley Rd
Oconomowoc, WI 53066-4500
Phone (262) 646-4411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33425WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Memorial Hospital Incorporated CurrentSince Aug 11, 2019 Accepting new patients
Mark H Rossing MDSC Psychiatry PastSince Jun 21, 1995 Accepting new patients
New Life Resources, Inc. Psychiatry PastSince Oct 22, 1998 Accepting new patients
Credence Therapy Associates Inc PastSince Aug 1, 2002 Accepting new patients
Shore Counseling and Consulting Clinic, S.C. PastSince Jan 1, 2004 Accepting new patients
Andrew J. Schroettner, MDSC Psychiatry PastSince Dec 3, 2003 Accepting new patients

Locations

1205 Corporate Center Dr
Oconomowoc, WI 53066
Phone (262) 567-4828

1230 Corporate Center Dr
Ste 400
Oconomowoc, WI 53066
Phone (262) 560-1527

34700 Valley Rd
Oconomowoc, WI 53066

Organizations & group practices 6

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184659591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRAIL",
            "address_2": "#211",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664641",
            "telephone_number": "262-567-1122",
            "fax_number": "262-567-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRAIL",
            "address_2": "#211",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664641",
            "telephone_number": "262-567-1122",
            "fax_number": "262-567-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSING",
        "first_name": "MARK",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "33425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31875700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.