Individual provider Active NPI

Allyson R. Ende, PSY.D.

  • Clinical Psychologist
  • Wausau, WI
National Provider Identifier
1487866455
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3264 Issued in WI
Practice address
227500 Rib Mountain Dr Ste 103
Wausau, WI 54401-5052
Phone
(715) 348-2828
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.006207 IL
Clinical Psychologist 103TC0700X 3264 WI Primary

Addresses

Primary practice location

227500 Rib Mountain Dr Ste 103
Wausau, WI 54401-5052

Mailing address

1720 Highwood LN
Wausau, WI 54403-8131
Phone (715) 574-4805

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
I20210706002855 WI Practitioner - Clinical Psychologist 2163824749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

227500 Rib Mountain Dr
Suite 103
Wausau, WI 54401-5052
Phone (715) 348-2828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.006207ILMDClinical Psychologist
3264WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allyson Ende, PSYD LLC CurrentSince Apr 26, 2021 Accepting new patients

Locations

227500 Rib Mountain Dr
Ste 103
Rib Mountain, WI 54401
Phone (715) 348-2828

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1487866455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 HIGHWOOD LN",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544038131",
            "telephone_number": "715-574-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227500 RIB MOUNTAIN DR STE 103",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015052",
            "telephone_number": "715-348-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDE",
        "first_name": "ALLYSON",
        "middle_name": "R.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.006207",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.