Individual provider Active NPI

Gabriella Ann Hangiandreou, MD

  • Child & Adolescent Psychiatry Physician
  • Wausau, WI
National Provider Identifier
1861407660
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
35579-020 Issued in WI
Practice address
705 S 24TH Ave
CHW Community Services Child and Family Counseling
Wausau, WI 54401-5242
Phone
(715) 848-1457
Fax
(715) 848-2959
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 35579-020 WI Primary
Psychiatry Physician 2084P0800X 35579 WI

Addresses

Primary practice location

705 S 24TH Ave
CHW Community Services Child and Family Counseling
Wausau, WI 54401-5242

Mailing address

705 S 24TH Ave
CHW Community Services Child and Family Counseling
Wausau, WI 54401-5242
Phone (715) 848-1457

Other identifiers 3

IdentifierTypeStateIssuer
32501200MedicaidWI
1861407660MedicaidWI
35579-20OtherWIWI STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35579WIMDPsychiatry Physician
35579-020WIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Human Services Board Serving North Central Heatlh Care Facility CurrentSince May 14, 2018 Accepting new patients
Human Services Board Serving North Central Health Care Facility CurrentSince May 14, 2018 Accepting new patients
Human Services Board Serving North Central Health Care Facility Current Accepting new patients

Locations

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

2400 Marshall St
Ste A
Wausau, WI 54403
Phone (715) 848-4600

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

Organizations & group practices 4

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1861407660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S 24TH AVE",
            "address_2": "CHW COMMUNITY SERVICES CHILD AND FAMILY COUNSELING",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015242",
            "telephone_number": "715-848-1457",
            "fax_number": "715-848-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S 24TH AVE",
            "address_2": "CHW COMMUNITY SERVICES CHILD AND FAMILY COUNSELING",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015242",
            "telephone_number": "715-848-1457",
            "fax_number": "715-848-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANGIANDREOU",
        "first_name": "GABRIELLA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "35579-020",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "35579",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32501200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861407660",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LICENSE",
            "identifier": "35579-20",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.