Alleah M Pynenberg

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4141-57 Issued in WI

Practice address

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

Phone

(920) 929-3500

Fax

(920) 929-3129

NPI assigned

Jun 13, 2024

Last updated

Jun 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fond Du Lac CountyGroup PAC ID 2668376245, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fond Du Lac County

  dba Department of Human Services Clinical Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fond Du Lac, WI
  • NPI 1053458935
  Medicare reassignment Care Compare group NPD
• Fond Du Lac County

  • Public Health or Welfare Agency
  • Fond Du Lac, WI
  • NPI 1285606178
  NPD

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1669215257",
    "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",
            "telephone_number": "920-929-3500",
            "fax_number": "920-929-3129"
        },
        {
            "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",
            "fax_number": "920-929-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYNENBERG",
        "first_name": "ALLEAH",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "4141-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Propson, APSW
• Christina Prus
• Amanda Pryz, RN
• Matthew Ryan Purcell, DO
• Joseph Puskar, M.D.
• Quality Cab LLC
• Leslie Mae Raddatz, LPC, SAC-IT
• Radiology Fond Du Lac LTD
• Radhika P Raj, MD
• Jamie Rambeau, MD

• Psychologist in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.