Active NPI
Brandon A Markel, PSY.D.
- Clinical Psychologist
- Milwaukee, WI
National Provider Identifier
1447685029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3201-57
- Practice address
- 1020 N 12TH St
Milwaukee, WI 53233-1308 - Phone
- (414) 219-6810
- NPI assigned
- Sep 13, 2013
- Last updated
- Dec 8, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1845 | AL | |
| Clinical Psychologist | 103TC0700X | 53 934 | MS | |
| Clinical Psychologist | 103TC0700X | 071.008706 | IL | |
| Clinical Psychologist | 103TC0700X | 3201-57 | WI | Primary |
Addresses
Primary practice location
1020 N 12TH St
Milwaukee, WI 53233-1308
Mailing address
1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-6810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447685029 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.008706 | IL | MD | Clinical Psychologist |
| 53 934 | MS | MD | Clinical Psychologist |
| 3201-57 | WI | MD | Clinical Psychologist |
| 1845 | AL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Behavioral Associates, PC | Clinical | Current | Accepting new patients |
| 360 Degrees Wellness & Coaching LLC | Current | Accepting new patients | |
| Noahs Ark Family Clinic Corp | Past | Accepting new patients |
Locations
225 E Deerpath
Ste 280
Lake Forest, IL 60045
Phone (847) 234-4400
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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-
- Clinical Social Worker
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- NPI 1497176523
-
dba Arizona Care Continuum
- Community/Behavioral Health Agency
- Phoenix, AZ
- NPI 1093855082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449532800000",
"number": "1447685029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 N 12TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331308",
"telephone_number": "414-219-6810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 N 12TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331308",
"telephone_number": "414-219-6810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKEL",
"first_name": "BRANDON",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-13",
"last_updated": "2015-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1845",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MS",
"license": "53 934",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.008706",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "3201-57",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1447685029",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.