Individual provider Active NPI

Geraldine Lucia Veneman-Fieschko

  • Clinical Social Worker
  • Verona, WI
National Provider Identifier
1356763411
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8031-123 Issued in WI
Practice address
3526 Sabaka TRL
Verona, WI 53593-9565
Phone
(608) 622-8020
NPI assigned
Jan 9, 2014
Last updated
Jan 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8031-123 WI Primary

Addresses

Primary practice location

3526 Sabaka TRL
Verona, WI 53593-9565

Mailing address

3526 Sabaka TRL
Verona, WI 53593-9565
Phone (608) 622-8020

Other names 1

  • Geraldine Lucia Veneman Other name

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
I20140512000524 WI Practitioner - Clinical Social Worker 5395978605 Practice locations: Madison, WI; Washington Island, WI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

313 Price PL
Suite 9
Madison, WI 53705-3250
Phone (608) 957-6572

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8031-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1356763411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3526 SABAKA TRL",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535939565",
            "telephone_number": "608-622-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 SABAKA TRL",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535939565",
            "telephone_number": "608-622-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEMAN-FIESCHKO",
        "first_name": "GERALDINE",
        "middle_name": "LUCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8031-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GERALDINE",
            "last_name": "VENEMAN",
            "middle_name": "LUCIA",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Verona, WI

Sources for this page

Verify at the official NPI Registry.