Individual provider Active NPI

Karen Erica Kersting, PHD

  • Clinical Psychologist
  • Milwaukee, WI
National Provider Identifier
1518310150
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3395-57 Issued in WI
Practice address
1121 E North Ave
Columbia St Marys Family Medicine
Milwaukee, WI 53212-3515
Phone
(414) 267-6502
Fax
(414) 267-3892
NPI assigned
Jul 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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 3395-57 WI Primary

Addresses

Primary practice location

1121 E North Ave
Columbia St Marys Family Medicine
Milwaukee, WI 53212-3515

Mailing address

1121 E North Ave
Columbia St Marys Family Medicine
Milwaukee, WI 53212-3515
Phone (414) 267-6502

Other identifiers 1

IdentifierTypeStateIssuer
1518310150MedicaidWI

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
I20160922000345 WI Practitioner - Clinical Psychologist 7214224013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

1121 E N Ave
Milwaukee, WI 53212-3515
Phone (414) 267-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3395-57WIMDClinical Psychologist
3395WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Oct 1, 2016 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

1121 E North Ave
Milwaukee, WI 53212
Phone (414) 267-6500

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1518310150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E NORTH AVE",
            "address_2": "COLUMBIA ST MARYS FAMILY MEDICINE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123515",
            "telephone_number": "414-267-6502",
            "fax_number": "414-267-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E NORTH AVE",
            "address_2": "COLUMBIA ST MARYS FAMILY MEDICINE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123515",
            "telephone_number": "414-267-6502",
            "fax_number": "414-267-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSTING",
        "first_name": "KAREN",
        "middle_name": "ERICA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3395-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518310150",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.