MR. SHANE V. MOISIO (MD) – Child & Adolescent Psychiatry Physician, NPI 1487601720
Child & Adolescent Psychiatry Physician
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Profile Insights
NPPES metrics only — not quality of care.
677 PSYCHIATRY in WI
Provider Addresses for MR. SHANE V. MOISIO (MD)
1919 W NORTH AVE STE 200
MILWAUKEE, WI 532051101
Phone: (414) 257-7610
Fax: (414) 266-3735
Type: Mailing
9000, West Wisconsin Avenue, Cannon Park, Wauwatosa, Milwaukee County, Wisconsin, 53226, United States
CHILD AND ADOLESCENT PSYCHIATRY
MILWAUKEE, WI 532264874
Phone: (414) 266-2932
Fax: (414) 266-3735
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2006-06-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060612000077 | I | Psychiatry | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 53205)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Psychiatry, Geriatric Psychiatry | WI | |
| P S Y C H I A T R Y | NE | |
| P S Y C H I A T R Y | WI | |
| P S Y C H I A T R Y | WI | |
| P S Y C H I A T R Y | KS | |
| P S Y C H I A T R Y | CA | |
| P S Y C H I A T R Y | MI | |
| Psychiatry, Pediatric Medicine | IL | |
| P S Y C H I A T R Y | MO | |
| P S Y C H I A T R Y | MA |
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