Judith Kisicki, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35592 Issued in WI

Practice address

Behavioral Medicine Center
721 American Avenue Suite 501
Waukesha, WI 53188

Phone

(262) 928-2396

Fax

(262) 544-1213

NPI assigned

Feb 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• County of Milwaukee

  • Psychiatry Physician
  • Milwaukee, WI
  • NPI 1831256353
  NPD (past)
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1306819925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL MEDICINE CENTER",
            "address_2": "721 AMERICAN AVENUE SUITE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-928-2396",
            "fax_number": "262-544-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL MEDICINE CENTER",
            "address_2": "721 AMERICAN AVENUE SUITE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-928-2396",
            "fax_number": "262-544-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISICKI",
        "first_name": "JUDITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "35592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32060400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol L Kinney, MS, LPC
• Ray Woodson Kinney, M.S.
• Rebecca M Kinnunen, LISW-S
• Sophia Kipp, MS
• Yanna T Kisala, O.D.
• Noelle C Kisting, MD
• Athena Kjell
• Kathleen Kay Klaas, M.D.
• Mark Alan Klaas, M.D.
• Adam Klamt, PHARMD

• Psychiatry Physician in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.