Individual provider Active NPI

Brandon Louis Neisewander, MD

  • Psychiatry Physician
  • Milwaukee, WI
National Provider Identifier
1396366639
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
83361-20 Issued in WI
Practice address
10012 W Capitol Dr
Milwaukee, WI 53222-1338
Phone
(414) 810-4844
Fax
(414) 810-4845
NPI assigned
Apr 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 83361-20 WI Primary

Addresses

Primary practice location

10012 W Capitol Dr
Milwaukee, WI 53222-1338

Mailing address

10012 W Capitol Dr
Milwaukee, WI 53222-1338
Phone (414) 810-4844

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417002929 WI Practitioner - PsychiatryPractitioner - Addiction Medicine 2567885072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Grove Clinic SCGroup PAC ID 2264476688, 15 clinicians

Practice addresses (Care Compare)

1400 75TH St
Kenosha, WI 53143-1544
Phone (414) 810-4844

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83361-20WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Grove Clinic, SC CurrentSince Apr 15, 2025 Accepting new patients

Locations

1400 75th St
Kenosha, WI 53143
Phone (262) 697-1820

10012 W Capitol Dr
Ste 101
Wauwatosa, WI 53222
Phone (414) 810-4844

10012 W Capitol Dr
Wauwatosa, WI 53222
Phone (414) 810-4844

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1396366639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221338",
            "telephone_number": "414-810-4844",
            "fax_number": "414-810-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221338",
            "telephone_number": "414-810-4844",
            "fax_number": "414-810-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISEWANDER",
        "first_name": "BRANDON",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "83361-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.