Individual provider Active NPI

Mariellen Fischer, PHD

  • Neurology Physician
  • Milwaukee, WI
National Provider Identifier
1205880564
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
1091 Issued in WI
Practice address
Froedtert & Med College Clin - West
9200 West Wisconsin Avenue
Milwaukee, WI 53226
Phone
(414) 805-3666
NPI assigned
May 20, 2006
Sex
Female
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
Neurology Physician 2084N0400X 1091 WI Primary

Addresses

Primary practice location

Froedtert & Med College Clin - West
9200 West Wisconsin Avenue
Milwaukee, WI 53226

Mailing address

9200 W Wisconsin Ave
Froedtert & Med College Clin - West
Milwaukee, WI 53226-3522

Other identifiers 1

IdentifierTypeStateIssuer
39033000MedicaidWI

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
I20130816000429 WI Practitioner - Clinical Psychologist 7911149125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Vermont College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Mental Health Consultants IncGroup PAC ID 5597665026, 8 clinicians

Practice addresses (Care Compare)

2600 N Mayfair
Suite 305
Wauwatosa, WI 53226-1303

2600 N Mayfair Rd
Suite 305
Wauwatosa, WI 53226-1303
Phone (414) 257-0233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1091WIMDProsthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Mental Health Consultants Inc CurrentSince Jun 4, 2013 Accepting new patients

Locations

2600 N Mayfair Rd
Ste 305
Wauwatosa, WI 53226
Phone (414) 257-0233

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205880564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "FROEDTERT & MED COLLEGE CLIN - WEST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FROEDTERT & MED COLLEGE CLIN - WEST",
            "address_2": "9200 WEST WISCONSIN AVENUE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-805-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "MARIELLEN",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "1091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39033000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.