Waukesha County
NPI 1629292651ActiveOrganization· Psychiatry & Neurology, Psychiatry· Waukesha, WI
Psychiatry & Neurology, Psychiatry in Waukesha, Wisconsin, registered in NPPES in April 2007. The authorized official on file is David M. Derosier, Credentialing Specialist.
Overview
| NPI | 1629292651 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 12, 2007 |
| Last updated in NPPES | Nov 10, 2025 |
| Certified by provider | Nov 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychiatry & Neurology, Psychiatry Primary | 2084P0800X | 907 | WI |
| Psychologist | 103T00000X | 907 | WI |
| Specialist | 174400000X | 907 | WI |
| Anesthesiology | 207L00000X | 907 | WI |
| Anesthesiology, Pain Medicine | 207LP2900X | 907 | WI |
| Family Medicine | 207Q00000X | 907 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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