Individual provider Active NPI

Andrea Marie Begotka, PHD

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1770675209
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2616057 Issued in WI
Practice address
9000 W Wisconsin Ave
Dept of Psychiatry
Milwaukee, WI 53226-3518
Phone
(414) 266-3005
Fax
(414) 266-3735
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2616057 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Dept of Psychiatry
Milwaukee, WI 53226-3518

Mailing address

PO Box 1997
Ms 750
Milwaukee, WI 53201-1997
Phone (414) 266-3005

Other identifiers 1

IdentifierTypeStateIssuer
1770675209MedicaidWI

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
I20210201001842 WI Practitioner - Clinical Psychologist 9537573605 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2616057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Jan 1, 2021 Accepting new patients

Locations

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: abegotka7376@direct.chw.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1770675209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1997",
            "address_2": "MS 750",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532011997",
            "telephone_number": "414-266-3005",
            "fax_number": "414-266-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "DEPT OF PSYCHIATRY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263518",
            "telephone_number": "414-266-3005",
            "fax_number": "414-266-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEGOTKA",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2616057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770675209",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.