Individual provider Active NPI

David John Bedrin, MSW

  • Clinical Social Worker
  • Brookfield, WI
National Provider Identifier
1801192893
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7594-123 Issued in WI
Practice address
13105 W Bluemound Rd
Suite 100
Brookfield, WI 53005-8022
Phone
(608) 209-5105
Fax
(262) 641-9791
NPI assigned
Feb 8, 2011
Last updated
Feb 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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 7594-123 WI Primary

Addresses

Primary practice location

13105 W Bluemound Rd
Suite 100
Brookfield, WI 53005-8022

Mailing address

13105 W Bluemound Rd
Suite 100
Brookfield, WI 53005-8022
Phone (608) 209-5105

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
I20110420000166 WI Practitioner - Clinical Social Worker 9739364605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways Counseling Center II LLCGroup PAC ID 7315970969, 9 clinicians

Practice addresses (Care Compare)

11121 W Oklahoma Ave
West Allis, WI 53227-4033
Phone (262) 641-9790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7594-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Counseling Center II LLC CurrentSince Mar 1, 2011 Accepting new patients
Allergic Diseases SC PastSince Mar 1, 2011 Accepting new patients

Locations

13105 W Bluemound Rd
Ste 100
Brookfield, WI 53005
Phone (262) 641-9790

11121 W Oklahoma Ave
West Allis, WI 53227
Phone (262) 641-9790

Organizations & group practices 2

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": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1801192893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 W BLUEMOUND RD",
            "address_2": "SUITE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058022",
            "telephone_number": "608-209-5105",
            "fax_number": "262-641-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13105 W BLUEMOUND RD",
            "address_2": "SUITE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058022",
            "telephone_number": "608-209-5105",
            "fax_number": "262-641-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDRIN",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7594-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.