Individual provider Active NPI

Tammy M Kelser, LMFT AND CSAC

  • Marriage & Family Therapist
  • Eau Claire, WI
National Provider Identifier
1477519676
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
747-124 Issued in WI
Practice address
221 W Madison Street
Eau Claire, WI 54703
Phone
(715) 832-5454
Fax
(715) 832-2991
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 747-124 WI Primary

Addresses

Primary practice location

221 W Madison Street
Eau Claire, WI 54703

Mailing address

E6270 866TH Ave
Colfax, WI 54730-4616
Phone (715) 239-5228

Other identifiers 3

IdentifierTypeStateIssuer
39395900MedicaidWI
86490OtherWISECURITY HEALTH PLAN
637871034983OtherMNPREFERRED ONE

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
I20240313004301 WI Practitioner - Marriage and Family Therapist 6406292374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PAGroup PAC ID 3678948809, 92 clinicians

Practice addresses (Care Compare)

Milwaukee, WI 53202
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
747-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.a. CurrentSince Feb 28, 2024 Accepting new patients
Omne Clinic Inc Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

777 N Jefferson St
Ste 408
Milwaukee, WI 53202
Phone (414) 367-8494

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1477519676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E6270 866TH AVE",
            "city": "COLFAX",
            "state": "WI",
            "postal_code": "547304616",
            "telephone_number": "715-239-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W MADISON STREET",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54703",
            "telephone_number": "715-832-5454",
            "fax_number": "715-832-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSER",
        "first_name": "TAMMY",
        "middle_name": "M",
        "credential": "LMFT AND CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "747-124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39395900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN",
            "identifier": "86490",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "637871034983",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.