Individual provider Active NPI

Stephan Siwiec, PHD

  • Clinical Psychologist
  • Madison, WI
National Provider Identifier
1487509972
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3987-57 Issued in WI
Practice address
6402 Odana Rd Ste 304
Madison, WI 53719-1123
Phone
(608) 465-4565
NPI assigned
Mar 2, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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 3987-57 WI Primary

Addresses

Primary practice location

6402 Odana Rd Ste 304
Madison, WI 53719-1123

Mailing address

4501 Bellingrath St
McFarland, WI 53558-8752
Phone (617) 721-3480

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
I20260402001826 WI Practitioner - Clinical Psychologist 0840775268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Keri Brown PHD, LLC Dba Pure Ocd TherapyGroup PAC ID 1850761800, 3 clinicians

Practice addresses (Care Compare)

6402 Odana Rd
Suite 304
Madison, WI 53719-1123
Phone (608) 370-2345

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3987-57WIMDClinical Psychologist

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": "1772409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1487509972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 BELLINGRATH ST",
            "city": "MCFARLAND",
            "state": "WI",
            "postal_code": "535588752",
            "telephone_number": "617-721-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6402 ODANA RD STE 304",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191123",
            "telephone_number": "608-465-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIWIEC",
        "first_name": "STEPHAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3987-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.