Individual provider Active NPI

Kathleen Ann Rozman, LCSW, MSW

  • Clinical Social Worker
  • Muskego, WI
National Provider Identifier
1558011510
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4118-123 Issued in WI
Practice address
W199S6754 Adrian Dr
Muskego, WI 53150-8286
Phone
(414) 704-9312
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4118-123 WI Primary

Addresses

Primary practice location

W199S6754 Adrian Dr
Muskego, WI 53150-8286

Mailing address

W199S6754 Adrian Dr
Muskego, WI 53150-8286
Phone (414) 704-9312

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
I20240312000249 WI Practitioner - Clinical Social Worker 9335585405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
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
4118-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.a. CurrentSince Feb 1, 2024 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 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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1558011510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W199S6754 ADRIAN DR",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508286",
            "telephone_number": "414-704-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W199S6754 ADRIAN DR",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508286",
            "telephone_number": "414-704-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZMAN",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "4118-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskego, WI

Sources for this page

Verify at the official NPI Registry.