Derek Schattl

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7544-226 Issued in WI

Practice address

1400 75TH St
Kenosha, WI 53143-1544

Phone

(262) 909-6008

Fax

(262) 764-8048

NPI assigned

Dec 18, 2023

Sex

Male

Sole proprietor

No

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

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• West Grove Clinic, SC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wauwatosa, WI
  • NPI 1518167477
  Medicare reassignment NPD

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1679341879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6328 73RD ST APT 106",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531431544",
            "telephone_number": "262-909-6008",
            "fax_number": "262-764-8048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Park Pl Ste 400",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549148271",
            "country_code": "US",
            "telephone_number": "920-574-3096",
            "fax_number": "920-574-3385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2545 Roosevelt Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433885",
            "country_code": "US",
            "telephone_number": "715-701-4456",
            "fax_number": "715-701-2030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10012 W Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532221338",
            "country_code": "US",
            "telephone_number": "414-810-4844",
            "fax_number": "414-810-4845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHATTL",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7544-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James J Sayler, DDS
• Louise A Schaefer, LPC-IT, SAC-IT
• James Schafer, DPT
• Andrew Joseph Schambers, MSN
• Amanda Lynn Scharninghausen, PTA
• Ryan J Schaul, MPT
• Elyse Scheeler, MS CFY/SLP
• Jessica G Schiffbauer, OD
• Carolyn Schiller
• Paul John Schissler, DC

• Professional Counselor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.