Individual provider Active NPI

Joellen Marie Kozlowski, PH.D.

  • Psychologist
  • Middleton, WI
National Provider Identifier
1710023130
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4018-57 Issued in WI
Practice address
2275 Deming Way
Middleton, WI 53562-5527
Phone
(608) 282-8200
NPI assigned
Jan 30, 2007
Last updated
May 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4018-57 WI Primary
Health Psychologist 103TH0004X 6301013973 MI

Addresses

Primary practice location

2275 Deming Way
Middleton, WI 53562-5527

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

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
I20230503002515 WI Practitioner - Clinical Psychologist 7618157090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2275 Deming Way
Suite 180
Middleton, WI 53562-5527
Phone (608) 282-8200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301013973MIMDHealth Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince May 1, 2023 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince May 1, 2023 Accepting new patients
McLaren Flint Past Accepting new patients

Locations

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

2275 Deming Way
Ste 180
Middleton, WI 53562
Phone (608) 282-8200

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Organizations & group practices 3

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1710023130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 DEMING WAY",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625527",
            "telephone_number": "608-282-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "JOELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "4018-57",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "MI",
            "license": "6301013973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

Verify at the official NPI Registry.