NPIMap

Individual provider Active NPI

Jean E Vogel, MD

  • Psychiatry Physician
  • Wausau, WI
National Provider Identifier
1396883005
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
76522 Issued in WI
Practice address
1100 Lake View Dr
Wausau, WI 54403-6799
Phone
(715) 848-4600
Fax
(203) 267-7674
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 76522 WI Primary
Psychiatry Physician 2084P0800X 032512 CT

Addresses

Primary practice location

1100 Lake View Dr
Wausau, WI 54403-6799

Mailing address

1100 Lake View Dr
Wausau, WI 54403-6799
Phone (715) 848-4600

Other practice location 1

2 Pomperaug Office Park
Suite 204
Southbury, CT 06488
Phone (203) 264-5240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220105000298 WI Practitioner - Psychiatry 7315961729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York at Buffalo School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 Marshall St
Suite a
Wausau, WI 54403-6738
Phone (715) 848-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032512CTMDPsychiatry Physician
76522WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Human Services Board Serving North Central Health Care Facility Current Accepting new patients
Human Services Board Serving North Central Health Care Facility CurrentSince Jan 1, 2022 Accepting new patients
Human Services Board Serving North Central Heatlh Care Facility CurrentSince Jan 1, 2022 Accepting new patients

Locations

1225 Langlade Rd
Antigo, WI 54409
Phone (715) 623-2394

607 N Sales St
Ste 309
Merrill, WI 54452
Phone (715) 536-9482

2400 Marshall St
Ste A
Wausau, WI 54403
Phone (715) 848-4600

1100 Lake View Dr
Wausau, WI 54403
Phone (715) 848-4454

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 and National Provider Directory roles.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1396883005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036799",
            "telephone_number": "715-848-4600",
            "fax_number": "203-267-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036799",
            "telephone_number": "715-848-4600",
            "fax_number": "203-267-7674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Pomperaug Office Park",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Southbury",
            "state": "CT",
            "postal_code": "06488",
            "country_code": "US",
            "telephone_number": "203-264-5240",
            "fax_number": "203-267-7674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOGEL",
        "first_name": "JEAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "76522",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "032512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.