Individual provider Active NPI

Callie J. Jarosch, OT

  • Occupational Therapist
  • Germantown, WI
National Provider Identifier
1801208137
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6064-26 Issued in WI
Practice address
N112W17975 Mequon Rd
Germantown, WI 53022-2425
Phone
(262) 532-7600
NPI assigned
May 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056-010621 IL
Occupational Therapist 225X00000X 6064-26 WI Primary

Addresses

Primary practice location

N112W17975 Mequon Rd
Germantown, WI 53022-2425

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
100066540MedicaidWI

Other names 1

  • Callie Budzisz Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cbudzisz107589@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170504002342 WI Practitioner - Occupational Therapist in Private Practice 5395960280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

N112 W17975 Mequon Rd
Germantown, WI 53022-2425
Phone (262) 532-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-010621ILMDOccupational Therapist
6064-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. CurrentSince Mar 2, 2020 Accepting new patients
Mercy Health System Corporation Occupational Therapist Current Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Mar 2, 2020 Accepting new patients
Mercy Health System Corporation Occupational Therapist CurrentSince Apr 13, 2017 Accepting new patients
Mercy Health System Corporation CurrentSince Apr 13, 2017 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

N112W17975 Mequon Rd
Germantown, WI 53022
Phone (262) 532-7600

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

1010 N Washington St
Janesville, WI 53548
Phone (608) 741-2430

1010 N Washington St
Ste 101
Janesville, WI 53548
Phone (608) 741-2430

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

557 N Washington St
Janesville, WI 53548
Phone (608) 754-6000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Organizations & group practices 5

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": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1801208137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N112W17975 MEQUON RD",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530222425",
            "telephone_number": "262-532-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAROSCH",
        "first_name": "CALLIE",
        "middle_name": "J.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-010621",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6064-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100066540",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbudzisz107589@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "N112W17975 Mequon Rd",
            "city": "Germantown",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530222425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "N112W17975 Mequon Rd",
            "city": "Germantown",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530222425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "BUDZISZ",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Germantown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.