NPIMap

Organization Active NPI

Waukesha County

  • Case Management Agency
  • Waukesha, WI
National Provider Identifier
1740403146
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
4307700 Issued in WI
Legal business name
WAUKESHA COUNTY
Practice address
514 Riverview Ave
Waukesha, WI 53188-3632
Phone
(262) 548-7399
Fax
(262) 970-6696
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
David M Derosier
Title
Credentialing Specialist
Phone
(262) 896-8431

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 4307700 WI Primary
Public Health or Welfare Agency 251K00000X 80259 WI
Community/Behavioral Health Agency 251S00000X 32976100 WI
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 42138400 WI
Psychiatric Hospital Unit 273R00000X 10063300 WI

Addresses

Primary practice location

514 Riverview Ave
Waukesha, WI 53188-3632

Mailing address

514 Riverview Ave
Waukesha, WI 53188-3631
Phone (262) 548-7399

Other identifiers 10

IdentifierTypeStateIssuer
10063326MedicaidWI
32976100MedicaidWI
43422400MedicaidWI
41760800MedicaidWV
43077000MedicaidWI
10063300MedicaidWI
32816300MedicaidWI
41760800MedicaidWI
42138400MedicaidWI
41861400MedicaidWI

Other names 1

  • Waukesha County (Fiscal) Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040124000130 WI Part B Supplier - Clinic/Group Practice 3971405481 Receives reassigned benefits from 77 practitioners
8 other NPIs on this enrollment
Practice locations: Waukesha, WI

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Waukesha CountyWaukesha, WI, CCN 524026 Hospital Operational/Managerial Control Jan 20, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 86

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 86

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1740403146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 RIVERVIEW AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883631",
            "telephone_number": "262-548-7399",
            "fax_number": "262-970-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 RIVERVIEW AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883632",
            "telephone_number": "262-548-7399",
            "fax_number": "262-970-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKESHA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "DEROSIER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "262-896-8431"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WI",
            "license": "4307700",
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "WI",
            "license": "80259",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "32976100",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "42138400",
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "WI",
            "license": "10063300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10063326",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32976100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43422400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41760800",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43077000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10063300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32816300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41760800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42138400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41861400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waukesha County (Fiscal)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.