Individual provider Active NPI

Erich A Roush, PSYD

  • Psychologist
  • Greenfield, WI
National Provider Identifier
1407236300
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3583-057 Issued in WI
Practice address
4455 S 108TH St
Greenfield, WI 53228-2504
Phone
(414) 427-5310
Fax
(414) 427-5311
NPI assigned
Jun 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2517-226 WI
Psychologist 103T00000X 3583-057 WI Primary

Addresses

Primary practice location

4455 S 108TH St
Greenfield, WI 53228-2504

Mailing address

4455 S 108TH St
Greenfield, WI 53228-2504
Phone (414) 427-5310

Other identifiers 1

IdentifierTypeStateIssuer
1407236300MedicaidWI

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
I20181226001798 WI Practitioner - Psychiatry 8527303338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

Merit-based Incentive Payment System (MIPS)

Final score
54.29 of 100Reported as group
Quality
20.24
Promoting interoperability
100
Improvement activities
0
Cost
77.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2517-226WIMDMental Health Counselor
3583-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Mar 1, 2024 Accepting new patients

Locations

4455 S 108th St
Milwaukee, WI 53228
Phone (414) 409-7593

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

Interoperability endpoints

  • Direct secure messaging: eroush780884@direct.froedtert.com

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1407236300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 S 108TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532282504",
            "telephone_number": "414-427-5310",
            "fax_number": "414-427-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 S 108TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532282504",
            "telephone_number": "414-427-5310",
            "fax_number": "414-427-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "ERICH",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2517-226",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3583-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407236300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.