Individual provider Active NPI

Gabriela Dieguez

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1982889465
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7405-123 Issued in WI
Practice address
2906 S 20TH St
Milwaukee, WI 53215-3732
Phone
(414) 672-1353
Fax
(414) 672-4265
NPI assigned
Jan 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7405-123 WI
Clinical Social Worker 1041C0700X 7405-123 WI Primary

Addresses

Primary practice location

2906 S 20TH St
Milwaukee, WI 53215-3732

Mailing address

PO Box 778789
Chicago, IL 60677-8789
Phone (414) 672-1353

Other identifiers 1

IdentifierTypeStateIssuer
43730300MedicaidWI

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
I20110831000716 WI Practitioner - Clinical Social Worker 1456521301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2906 S 20TH St
Milwaukee, WI 53215-3732
Phone (414) 672-1353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sixteenth Street Community Health Centers, Inc. CurrentSince Jul 19, 2011 Accepting new patients
16TH Street Community Health Center Inc. CurrentSince Jul 19, 2011 Accepting new patients

Locations

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204

4570 S 27th St
Milwaukee, WI 53221
Phone (414) 325-8720

1635 W National Ave
Milwaukee, WI 53204
Phone (262) 408-5094

2906 S 20th St
Milwaukee, WI 53215
Phone (414) 385-8800

309 E North St
Waukesha, WI 53188
Phone (262) 408-2530

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1982889465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778789",
            "telephone_number": "414-672-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 S 20TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153732",
            "telephone_number": "414-672-1353",
            "fax_number": "414-672-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEGUEZ",
        "first_name": "GABRIELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "7405-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7405-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43730300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.