Individual provider Active NPI

Barbara Rebekah Demares, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Middleton, WI
National Provider Identifier
1336775170
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9874 Issued in WI
Practice address
3169 Deming Way
Middleton, WI 53562-1435
Phone
(608) 716-8288
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9874 WI Primary

Addresses

Primary practice location

3169 Deming Way
Middleton, WI 53562-1435

Mailing address

1134 Ridge Creek Cir Unit 101
Waukesha, WI 53186-4214
Phone (414) 758-0623

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230508001492 WI Practitioner - Nurse Practitioner 7214392646 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9874WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Physician Practices LLC Psychiatric/Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Watertown Physician Practices LLC Current Accepting new patients
Oak Medical SC Psychiatric/Mental Health CurrentSince May 1, 2023 Accepting new patients
Watertown Physician Practices LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

W173N10915 Bernies Way
Germantown, WI 53022
Phone (262) 509-3300

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

123 Hospital Dr
Ste 110
Watertown, WI 53098
Phone (920) 261-0672

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

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": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1336775170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 RIDGE CREEK CIR UNIT 101",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864214",
            "telephone_number": "414-758-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 DEMING WAY",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535621435",
            "telephone_number": "608-716-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARES",
        "first_name": "BARBARA",
        "middle_name": "REBEKAH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "9874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

Verify at the official NPI Registry.