Individual provider Active NPI

Jamie Rambeau, MD

  • Psychiatry Physician
  • Fond Du Lac, WI
National Provider Identifier
1649248923
Registry record updated Oct 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
42106 Issued in WI
Practice address
459 E 1St St
Fond Du Lac, WI 54935-4505
Phone
(920) 929-3500
NPI assigned
Mar 10, 2006
Last updated
Oct 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 42106 WI Primary

Addresses

Primary practice location

459 E 1St St
Fond Du Lac, WI 54935-4505

Mailing address

459 E 1St St
Fond Du Lac, WI 54935-4505

Other identifiers 2

IdentifierTypeStateIssuer
1649248923MedicaidWA
1649248923MedicaidID

Other names 1

  • Jamie Warren Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110106000959 ID Practitioner - Psychiatry 4981633641
I20191127000502 WI Practitioner - Psychiatry 4981633641

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of New Mexico School of Medicine, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

459 E 1St St
Fond Du Lac, WI 54935-4505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42106WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fond Du Lac County CurrentSince Oct 14, 2019 Accepting new patients
Fond Du Lac County CurrentSince Oct 14, 2019 Accepting new patients
Advantage Behavioral Health Systems PastSince Nov 4, 2009 Accepting new patients
Community Behavioral Health Hospital-Fergus Falls PastSince Oct 1, 2024 Accepting new patients

Locations

459 E 1st St
Fond du Lac, WI 54935
Phone (920) 929-3500

Organizations & group practices 4

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572048000000",
    "number": "1649248923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354505",
            "telephone_number": "920-929-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMBEAU",
        "first_name": "JAMIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2019-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "42106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649248923",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649248923",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "WARREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.