Individual provider Active NPI

Michael John Orrico, PH.D.

  • Psychologist
  • Prairie Du Sac, WI
National Provider Identifier
1427255678
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2424-057 Issued in WI
Practice address
560 4TH St
Prairie Du Sac, WI 53578-1136
Phone
(608) 643-3663
NPI assigned
Jun 29, 2007
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2424-057 WI Primary

Addresses

Primary practice location

560 4TH St
Prairie Du Sac, WI 53578-1136

Mailing address

560 4TH St
Prairie Du Sac, WI 53578-1136
Phone (608) 643-3663

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
I20080102000472 WI Practitioner - Clinical Psychologist 9931289071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathway to Wellness Community Clinic SCGroup PAC ID 4981995479, 4 clinicians

Practice addresses (Care Compare)

560 4TH St
Prairie Du Sac, WI 53578-1136
Phone (608) 643-3663

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2424-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathway to Wellness Community Clinic SC Psychologist CurrentSince Jul 1, 2016 Accepting new patients
Erc Wisconsin, LLC PastSince Aug 8, 2021 Accepting new patients

Locations

560 4th St
Prairie du Sac, WI 53578
Phone (608) 643-3663

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1427255678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 4TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535781136",
            "telephone_number": "608-643-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 4TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535781136",
            "telephone_number": "608-643-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORRICO",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2424-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Du Sac, WI

Sources for this page

Verify at the official NPI Registry.