Krista Supinger, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3451 Issued in WI

Practice address

333 W Brown Deer Rd Unit G1202
Milwaukee, WI 53217-2372

Phone

(414) 745-9325

NPI assigned

Apr 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Krista Hernandez Former name

Medicare fee-for-service enrollment

Enrolled in WI, AL2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Krista Supinger Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1942933163
  Medicare reassignment NPD Authorized official
• Veterans Recovery Resources

  • Substance Abuse Rehabilitation Facility
  • Mobile, AL
  • NPI 1285140004
  Medicare reassignment NPD
• Veterans Recovery Resources

  • Substance Abuse Rehabilitation Facility
  • Mobile, AL
  • NPI 1699510198
  NPD (past)

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1457770398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W BROWN DEER RD UNIT G1202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532172372",
            "telephone_number": "414-745-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W BROWN DEER RD UNIT G1202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532172372",
            "telephone_number": "414-745-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPINGER",
        "first_name": "KRISTA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100066773",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K400379168",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "HERNANDEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Superior Care Home Health
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• Supportive Living Home Health Care
• Supportive Living Home Health Care

• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.