Individual provider Active NPI

Sidney G Boersma, LCSW

  • Clinical Social Worker
  • Rock Island, IL
National Provider Identifier
1992800775
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2198-123 Issued in WI
Practice address
1 Rock Island Arsenal
Rock Island, IL 61299-7530
Phone
(309) 782-4910
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 152227 WI
Clinical Social Worker 1041C0700X 2198-123 WI Primary

Addresses

Primary practice location

1 Rock Island Arsenal
Rock Island, IL 61299-7530

Mailing address

243 E McKinley St
Stoughton, WI 53589-1626
Phone (608) 873-4859

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
I20050211000117 WI Practitioner - Clinical Social Worker 3870545460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oceanhawk Counseling Alternatives LLCGroup PAC ID 7810098886, 2 clinicians

Practice addresses (Care Compare)

3185 Deer Point Dr
Suite a
Stoughton, WI 53589-3773
Phone 60887378388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
152227WIMDClinical Social Worker
2198-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oceanhawk Counseling Alternatives LLC CurrentSince Dec 15, 2022 Accepting new patients

Locations

3185 Deer Point Dr
Ste A
Stoughton, WI 53589
Phone (608) 873-7838

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1992800775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 E MCKINLEY ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891626",
            "telephone_number": "608-873-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROCK ISLAND ARSENAL",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612997530",
            "telephone_number": "309-782-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERSMA",
        "first_name": "SIDNEY",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "152227",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2198-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.