Individual provider Active NPI

Katherine Anne Watermolen, PSY.D

  • Psychologist
  • Middleton, WI
National Provider Identifier
1356495931
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2743-57 Issued in WI
Practice address
2275 Deming Way Ste 180
Middleton, WI 53562-5527
Phone
(608) 282-8200
Fax
(608) 262-9246
NPI assigned
Jan 22, 2007
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2743-57 WI Primary

Addresses

Primary practice location

2275 Deming Way Ste 180
Middleton, WI 53562-5527

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other identifiers 1

IdentifierTypeStateIssuer
1356495931MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwatermolen1039224@direct.uwhealth.org

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
I20081205000744 WI Practitioner - Clinical Psychologist 2860553062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2275 Deming Way
Suite 180
Middleton, WI 53562-5527
Phone (608) 282-8200

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2743-57WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Feb 7, 2022 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince May 6, 2019 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince May 6, 2019 Accepting new patients

Locations

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

1265 John Q Hammons Dr
Madison, WI 53717

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

6001 Research Park Blvd
Madison, WI 53719
Phone (608) 232-3171

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

2275 Deming Way
Ste 180
Middleton, WI 53562
Phone (608) 282-8200

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Interoperability endpoints

  • Direct secure messaging: kschmiedlin30541@direct.uwhealth.org
  • Direct secure messaging: kwatermolen1039224@direct.uwhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1356495931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 DEMING WAY STE 180",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625527",
            "telephone_number": "608-282-8200",
            "fax_number": "608-262-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMOLEN",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2743-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356495931",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwatermolen1039224@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "2275 Deming Way Ste 180",
            "city": "Middleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535625527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

Verify at the official NPI Registry.