Individual provider Active NPI

Julie Lewis Rickert, PSYD

  • Clinical Psychologist
  • Menomonee Falls, WI
National Provider Identifier
1215035944
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3455 Issued in WI
Practice address
W180N8000 Town Hall Rd
Department of Psychiatry
Menomonee Falls, WI 53051-4002
Phone
(262) 255-2500
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 296 ND
Clinical Psychologist 103TC0700X 3455 WI Primary

Addresses

Primary practice location

W180N8000 Town Hall Rd
Department of Psychiatry
Menomonee Falls, WI 53051-4002

Mailing address

W180N8000 Town Hall Rd
Department of Psychiatry
Menomonee Falls, WI 53051-4002
Phone (262) 255-2500

Other identifiers 2

IdentifierTypeStateIssuer
1215035944MedicaidWI
18980MedicaidND

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
I20170315000479 WI Practitioner - Clinical Psychologist 5597958587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Baylor College of Dentistry/Texas a&M University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002
Phone (262) 255-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince May 1, 2017 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 21, 2017 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 21, 2017 Accepting new patients
Community Memorial Hospital of Menomonee Falls, Inc Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Organizations & group practices 4

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1215035944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W180N8000 TOWN HALL RD",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514002",
            "telephone_number": "262-255-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W180N8000 TOWN HALL RD",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514002",
            "telephone_number": "262-255-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKERT",
        "first_name": "JULIE",
        "middle_name": "LEWIS",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "296",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215035944",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18980",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.