Mark Pushkash, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

908 Issued in WI

Practice address

1545 S Layton Blvd
Suite 307
Milwaukee, WI 53215-1924

Phone

(414) 217-2858

NPI assigned

May 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Aurora Psychiatric Hospital, Inc.

  • Psychiatric Hospital
  • Wauwatosa, WI
  • NPI 1881627438
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366497851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 N MARYLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111651",
            "telephone_number": "414-217-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 S LAYTON BLVD",
            "address_2": "SUITE 307",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151924",
            "telephone_number": "414-217-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSHKASH",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39038000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Purposeful Living, LLC
• Sarah Purpura, RD
• Puru Health Care LLC
• Stephanie Puryear, OTR/L
• Jamie Lee Puschnig, APNP
• Patricia Marie Puskarich, RD
• Ajeng Juwita Puspitasari, PHD
• Megan Sue Puthoff, FNP-C
• Julie A Putman, RN, MSN
• Michael Putman, M.D.

• Clinical Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.