Active NPI
William M Buzogany, MD
- Child & Adolescent Psychiatry Physician
- Dousman, WI
National Provider Identifier
1184800880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 13618020
- Practice address
- W350 S1401 Waterville Road
Lad Lake Inc
Dousman, WI 53118 - Phone
- (262) 965-2131
- Fax
- (262) 965-4107
- NPI assigned
- Jan 14, 2008
- Last updated
- Jan 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 13618020 | WI | Primary |
Addresses
Primary practice location
W350 S1401 Waterville Road
Lad Lake Inc
Dousman, WI 53118
Mailing address
PO Box 158
Lad Lake Inc
Dousman, WI 53118
Phone (262) 965-2131
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13618020 | Other | WI | WIS REG LICENSING |
| 32181300 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13618020 | WI | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lad Lake, Inc. | Past | Accepting new patients |
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.
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Dousman, WI
- NPI 1114196854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1184800880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 158",
"address_2": "LAD LAKE INC",
"city": "DOUSMAN",
"state": "WI",
"postal_code": "53118",
"telephone_number": "262-965-2131",
"fax_number": "262-965-4107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W350 S1401 WATERVILLE ROAD",
"address_2": "LAD LAKE INC",
"city": "DOUSMAN",
"state": "WI",
"postal_code": "53118",
"telephone_number": "262-965-2131",
"fax_number": "262-965-4107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUZOGANY",
"first_name": "WILLIAM",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-14",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "WI",
"license": "13618020",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WIS REG LICENSING",
"identifier": "13618020",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32181300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dousman, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.