Individual provider Active NPI

Brett Michael Masbruch, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Madison, WI
National Provider Identifier
1396887857
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
14161 Issued in WI
Practice address
3113 E Washington Ave
Madison, WI 53704-4330
Phone
(608) 242-0220
Fax
(608) 242-1166
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 14161 WI Primary

Addresses

Primary practice location

3113 E Washington Ave
Madison, WI 53704-4330

Mailing address

3113 E Washington Ave
Madison, WI 53704-4330
Phone (608) 242-0220

Other identifiers 1

IdentifierTypeStateIssuer
42019500MedicaidWI

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
I20240403000535 WI Practitioner - Mental Health Counselor 3870931355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Journey Mental Health Center IncGroup PAC ID 6406844661, 16 clinicians

Practice addresses (Care Compare)

49 Kessel CT
Madison, WI 53711-6200
Phone (608) 280-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14161WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Mental Health Center, Inc. CurrentSince Feb 19, 2024 Accepting new patients
Madison Health Services Past Accepting new patients

Locations

25 Kessel Ct
Ste 105
Madison, WI 53711
Phone (608) 280-2636

49 Kessel Ct
Madison, WI 53711
Phone (608) 280-2510

Organizations & group practices 2

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396887857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044330",
            "telephone_number": "608-242-0220",
            "fax_number": "608-242-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044330",
            "telephone_number": "608-242-0220",
            "fax_number": "608-242-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASBRUCH",
        "first_name": "BRETT",
        "middle_name": "MICHAEL",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "14161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42019500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.