NPIMap

Organization Active NPI

Waukesha Health System, Inc.

Doing business as Behavioral Medicine Center

  • Clinic/Center
  • Waukesha, WI
National Provider Identifier
1346353695
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1976 Issued in WI
Legal business name
WAUKESHA HEALTH SYSTEM, INC.
Doing business as
Behavioral Medicine Center
Practice address
721 American Ave
Suite 501
Waukesha, WI 53188-5071
Phone
(262) 928-2396
Fax
(262) 544-1213
NPI assigned
Aug 17, 2006
Last updated
Dec 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Authorized official

Name
Mr. Frederick L SyrjanenNPI 1437323136
Title
Executive Director
Phone
(252) 928-2382

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 1976 WI Primary

Addresses

Primary practice location

721 American Ave
Suite 501
Waukesha, WI 53188-5071

Mailing address

721 American Ave
Suite 501
Waukesha, WI 53188-5071
Phone (262) 928-2396

Other names 1

  • Behavioral Medicine Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422001085 WI Part B Supplier - Clinic/Group Practice 4082519517 Receives reassigned benefits from 1 practitioner
3 other NPIs on this enrollment
Practice locations: Mukwonago, WI; Waukesha, WI

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Blair Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1346353695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 AMERICAN AVE",
            "address_2": "SUITE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885071",
            "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": "721 AMERICAN AVE",
            "address_2": "SUITE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885071",
            "telephone_number": "262-928-2396",
            "fax_number": "262-544-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKESHA HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "SYRJANEN",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-928-2382",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "1976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Behavioral Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.