Individual provider Active NPI

Jodi Streicher-Bremer, PSYD

  • Psychologist
  • Madison, WI
National Provider Identifier
1689758005
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2642-057 Issued in WI
Practice address
1619 Monroe St
Madison, WI 53711-2063
Phone
(608) 255-9330
Fax
(608) 255-7810
NPI assigned
Oct 24, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2642-057 WI Primary

Addresses

Primary practice location

1619 Monroe St
Madison, WI 53711-2063

Mailing address

1619 Monroe St
Madison, WI 53711-2063
Phone (608) 255-9330

Other practice location 1

7617 Mineral Point Rd
Ste 300
Madison, WI 53717-1623
Phone (608) 833-9290

Other identifiers 2

IdentifierTypeStateIssuer
39153800MedicaidWI
002884027OtherWIMEDICARE

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
I20070723000311 WI Practitioner - Clinical Psychologist 6406957307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integral Psychology CenterGroup PAC ID 7810092996, 5 clinicians

Practice addresses (Care Compare)

1619 Monroe St
Madison, WI 53711-2063
Phone (608) 255-9330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2642-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Psychology Center CurrentSince Oct 26, 2017 Accepting new patients
Streicher-Bremer Psychotherapy SC Psychologist Past Accepting new patients

Locations

1619 Monroe St
Madison, WI 53711
Phone (608) 225-2341

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689758005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112063",
            "telephone_number": "608-255-9330",
            "fax_number": "608-255-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112063",
            "telephone_number": "608-255-9330",
            "fax_number": "608-255-7810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7617 Mineral Point Rd",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537171623",
            "country_code": "US",
            "telephone_number": "608-833-9290",
            "fax_number": "608-833-9691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREICHER-BREMER",
        "first_name": "JODI",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2642-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39153800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "002884027",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.