Individual provider Active NPI

Ajay R Wadhwa, DR

  • Clinical Psychologist
  • Milwaukee, WI
National Provider Identifier
1407923790
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2851-57 Issued in WI
Practice address
229 E Wisconsin Ave
Suite 600
Milwaukee, WI 53202-4230
Phone
(414) 224-3737
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2851-57 WI Primary

Addresses

Primary practice location

229 E Wisconsin Ave
Suite 600
Milwaukee, WI 53202-4230

Mailing address

229 E Wisconsin Ave
Suite 600
Milwaukee, WI 53202-4230
Phone (414) 224-3737

Other identifiers 1

IdentifierTypeStateIssuer
43705900MedicaidWI

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
I20120425000632 WI Practitioner - Clinical Psychologist 3870755598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatric Consultants and Therapists SCGroup PAC ID 5092740985, 12 clinicians

Practice addresses (Care Compare)

229 E Wisconsin Ave
Milwaukee, WI 53202-4212
Phone (414) 224-3737

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2851-57WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Consultants & Therapists, SC CurrentSince Mar 13, 2012 Accepting new patients

Locations

229 E Wisconsin Ave
Ste 60
Milwaukee, WI 53202
Phone (414) 224-3737

229 E Wisconsin Ave
Ste 600
Milwaukee, WI 53202
Phone (414) 224-3737

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1407923790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 E WISCONSIN AVE",
            "address_2": "SUITE 600",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024230",
            "telephone_number": "414-224-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 E WISCONSIN AVE",
            "address_2": "SUITE 600",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024230",
            "telephone_number": "414-224-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADHWA",
        "first_name": "AJAY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2851-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43705900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.