Jon P Marschall, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1872-057 Issued in WI

Practice address

721 American Ave
Suite 501
Waukesha, WI 53188-5071

Phone

(262) 928-2396

Fax

(262) 544-1213

NPI assigned

Nov 13, 2006

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

Other identifiers 1

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, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmarschall13458@direct.phci.org

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.

• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440
  Medicare reassignment Care Compare group NPD
• Prohealth Medical Group Inc

  • Internal Medicine Physician
  • Watertown, WI
  • NPI 1629119417
  NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700957370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 AMERICAN AVE",
            "address_2": "SUITE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885071",
            "telephone_number": "262-928-2396",
            "fax_number": "262-544-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 AMERICAN AVE",
            "address_2": "SUITE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885071",
            "telephone_number": "262-928-2396",
            "fax_number": "262-544-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSCHALL",
        "first_name": "JON",
        "middle_name": "P",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1872-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39606700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna Lynn Marincic, MSW, LCSW
• Mark J Kneepkens
• Athena Markopoulos, LPC, MA
• Jami Markos
• Luke Marks, LPC-IT
• Martin W. Kern,M.D.,S.C.
• Brianna Nicole Martin, COTA/L
• Francesca Jean Martin, D.D.S.
• Gina Marie Martin, RN
• Kim Martin, LPN

• Clinical Psychologist in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.