Individual provider Active NPI

Seta Rusinak, PSY.D.

  • Clinical Psychologist
  • Madison, WI
National Provider Identifier
1710405311
Registry record updated Sep 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3472-57 Issued in WI
Practice address
122 E Olin Ave Ste 220
Madison, WI 53713-1482
Phone
(608) 255-9119
NPI assigned
Sep 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071009519 IL
Clinical Psychologist 103TC0700X 3472-57 WI Primary

Addresses

Primary practice location

122 E Olin Ave Ste 220
Madison, WI 53713-1482

Mailing address

3235 Harmony St
Sun Prairie, WI 53590-7035
Phone (317) 313-7783

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
I20240207003570 WI Practitioner - Clinical Psychologist 0244673135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

715 Hill St
Suite 132
Madison, WI 53705-3572
Phone (608) 535-9428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071009519ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rusinak Psychology LLC Clinical CurrentSince Dec 11, 2023 Accepting new patients
Laura Clark Counseling, LLC Clinical PastSince Nov 29, 2020 Accepting new patients
Psychology Associates LLP PastSince Oct 10, 2005 Accepting new patients

Locations

715 Hill St
Ste 132
Madison, WI 53705
Phone (608) 255-9119

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504396800000",
    "number": "1710405311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 HARMONY ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535907035",
            "telephone_number": "317-313-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E OLIN AVE STE 220",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131482",
            "telephone_number": "608-255-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSINAK",
        "first_name": "SETA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-03",
        "last_updated": "2017-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009519",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3472-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.