REGAN R EBERHART (LCSW) – Clinical Social Worker, NPI 1508911959

REGAN R EBERHART (LCSW) is a healthcare provider. based in Menasha, Wisconsin. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. RC00056209 (WA). The NPI Number for REGAN R EBERHART (LCSW) is 1508911959

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
REGAN R EBERHART (LCSW)
NPI
1508911959
Phone
(920) 720-2300
Address
1095 MIDWAY RD
Enumeration Date
24 January 2007
Last Update Date
15 November 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9207202300
Graduation Year
2004 (22 years ago)
PAC ID
0244496461
Group Practice PAC ID
1759294887
Professional Enrollment ID
I20171205002561
Address ID
WI549521115ME1095XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience75
Completeness75
Years active:19State licenses:3Digital endpointsOther names

1,447 CLINICAL SOCIAL WORKER in WI

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Provider Addresses for REGAN R EBERHART (LCSW)

  • 1095, Midway Road, Menasha, Winnebago County, Wisconsin, 54952, United States

    MENASHA, WI 549521115

    Phone: (920) 720-2300

    Mailing address matches the actual address.

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: 2017-12-05

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171205002561IClinical Social WorkerWITBD

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.

Verify on CMS Revalidation Lookup Tool

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 54952)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759294887View full group profile
NameSpecialtyState
Family PracticeWI
Family PracticeWI
-FL
Hospitalist, Internal MedicineMI
P S Y C H I A T R YWI
-WI
-WA
Physician AssistantWI
Family PracticeWI
Nurse PractitionerWI

Reviews

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Frequently asked questions

What is the 10-digit NPI for REGAN R EBERHART (LCSW)?
REGAN R EBERHART (LCSW) — NPI 1508911959 — is the standard way to identify this listing.
Is REGAN R EBERHART (LCSW) listed as active for patients and plans?
The listing shows REGAN R EBERHART (LCSW) as active in the NPI system.
What taxonomy line describes REGAN R EBERHART (LCSW)?
For research purposes, treat REGAN R EBERHART (LCSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for REGAN R EBERHART (LCSW)?
REGAN R EBERHART (LCSW)'s geographic hint is Menasha, Wisconsin in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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