Rosita M Fernandez

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3535 Issued in WI

Practice address

318 Margaret CT
Burlington, WI 53105-2330

Phone

(812) 201-3912

NPI assigned

Sep 15, 2017

Last updated

Jan 8, 2022By the provider in NPPES

Sex

Female

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, WI2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wisconsin Psychology Associates, LLC

  • Health Service Psychologist
  • Burlington, WI
  • NPI 1639830151
  Medicare reassignment NPD Authorized official
• Coffee Clutch Counseling Services, LLC

  • Clinical Social Worker
  • Terre Haute, IN
  • NPI 1477027696
  Medicare reassignment NPD
• Hamilton Center, Inc.

  • Community/Behavioral Health Agency
  • Terre Haute, IN
  • NPI 1205980901
  Medicare reassignment NPD
• Wisconsin Psychology Associates, LLC

  • Health Service Psychologist
  • Burlington, WI
  • NPI 1427709351
  NPD Authorized official
• Hamilton Center Inc.

  dba WIN Recovery-Knox

  • Methadone Clinic
  • Vincennes, IN
  • NPI 1265053854
  NPD

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641600000000",
    "number": "1376062851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 MARGARET CT",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052330",
            "telephone_number": "812-201-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MARGARET CT",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052330",
            "telephone_number": "812-201-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ROSITA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2022-01-08",
        "certification_date": "2022-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376062851",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007198IN",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://rose-fernandez.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Client Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "318 Margaret Ct",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531052330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Holly Fales, COTA
• Family Vision & Contact Lens Centers, S.C.
• Family Vision & Contact Lens Centers, S.C.
• David Feather, PT, DPT
• Scott Michael Ferguson, DC,ATC
• Emily Rose Fillicetti, L.AC., MSOM
• Ashley Fitzsimmons-Olsen, SLP
• Paula E Flaherty, MS
• Michele G Fojas, NP
• Randy John Folker, M.D.

• Psychologist in Burlington, WI
• Providers in Burlington, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.