Waukesha Health System, Inc.
Organization Active NPI Clinic/Center · Waukesha, WI
NPI 1346353695 · NPPES record last updated Dec 14, 2022
Key facts
- NPI
- 1346353695
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 1976 (WI)
- Legal business name
- WAUKESHA HEALTH SYSTEM, INC.
- Practice address
- 721 American Ave
Suite 501
Waukesha, WI 53188-5071 - Phone
- (262) 928-2396
- Fax
- (262) 544-1213
- NPI assigned
- Aug 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Frederick L Syrjanen
- Title
- Executive Director
- Phone
- (252) 928-2382
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 6
Practitioners 36
-
Ryan Sershon, LCSW
-
Emily Gill Alexander, LCSW
-
Terese Eileen Andrle, M.D.
-
Kathleen Ball, LCSW
-
Subhadeep Barman, M.D.
-
Amy L Biwer, LPC
-
Daniel A Bizjak, BS, CSAC, ICS
-
Elizabeth A Borst, PMHNP
-
Joanna Buck, MD
-
Karen Copeland, MS
-
Aaron Foreman, LPC
-
Lynette Gunville, MED
-
Michelle Kathryn Heaton, D.O.
-
Julianne M Kaczmarek, LCSW
-
Matthew Ray Kangas, LCSW
-
Rebecca M Kinnunen, LISW-S
-
Mollie Klein, APNP
-
Janine Allison Kolinski, APNP, CARN-AP
-
Nikki Sean Kroner, APNP
-
Carrie Laux, LCSW
-
Ellen M Majowski, LCSW
-
Sarita Makhija, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Blair Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 1976 | WI | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42125500 | Medicaid | WV |
Other names
- Behavioral Medicine Center
Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.