Individual provider Active NPI

John M Oestreicher, PHD

  • Psychologist
  • Appleton, WI
National Provider Identifier
1619962024
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1822 Issued in WI
Practice address
1531 S Madison St
Appleton, WI 54915-1800
Phone
(920) 730-4411
NPI assigned
Sep 13, 2005
Last updated
Sep 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1822 WI Primary

Addresses

Primary practice location

1531 S Madison St
Appleton, WI 54915-1800

Mailing address

1531 S Madison St
Appleton, WI 54915-1800
Phone (920) 730-4411

Other identifiers 1

IdentifierTypeStateIssuer
39106700MedicaidWI

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
I20100806000647 WI Practitioner - Clinical Psychologist 7214060599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1501 S Madison St
Appleton, WI 54915-1846
Phone (920) 738-2000

1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 738-2000

1531 S Madison St
Appleton, WI 54915-1800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Feb 24, 2010 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Feb 24, 2010 Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1531 S Madison St
Appleton, WI 54915
Phone (920) 730-4411

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

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 2

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1619962024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151800",
            "telephone_number": "920-730-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151800",
            "telephone_number": "920-730-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OESTREICHER",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39106700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.