Individual provider Active NPI

Bonnie Buschke

  • Clinical Social Worker
  • Oregon, WI
National Provider Identifier
1770106023
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9303-123 Issued in WI
Practice address
481 Medinah St
Oregon, WI 53575-3875
Phone
(608) 515-3675
NPI assigned
May 21, 2020
Last updated
May 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9303-123 WI Primary

Addresses

Primary practice location

481 Medinah St
Oregon, WI 53575-3875

Mailing address

481 Medinah St
Oregon, WI 53575-3875
Phone (608) 515-3675

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
I20220714000240 WI Practitioner - Clinical Social Worker 7416338058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Mental Health Services,LLCGroup PAC ID 0143393884, 9 clinicians

Practice addresses (Care Compare)

165 W Netherwood St
Suite a
Oregon, WI 53575-1107
Phone 6088355050102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Mental Health Services,LLC CurrentSince Jun 14, 2022 Accepting new patients

Locations

165 W Netherwood St
Oregon, WI 53575
Phone (608) 408-9556

165 W Netherwood St
Ste A
Oregon, WI 53575
Phone (608) 835-5050

Organizations & group practices 1

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": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1770106023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 MEDINAH ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753875",
            "telephone_number": "608-515-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 MEDINAH ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753875",
            "telephone_number": "608-515-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCHKE",
        "first_name": "BONNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9303-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, WI

Sources for this page

Verify at the official NPI Registry.