Unknown Individual – Psychiatry Physician, NPI 1528091030
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
711 N LYNNDALE DR STE 1A
APPLETON, WI 549143078
Phone: (920) 560-4525
Fax: (920) 560-6618
Type: Mailing
1611, South Madison Street, Appleton, Outagamie County, Wisconsin, 54915, United States
APPLETON, WI 549151844
Phone: (920) 730-5470
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 50 Open Payments records for all available years, with a total value of $930.
Total Amount is formed as General ($930) + Research ($0) + Ownership ($0) = $930.
Last reported payment date: 2024-07-09 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($125).
Total Amount
$930
General + Research + Ownership
Payments
50
Total payment records
General Amount
$930
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Otsuka America Pharmaceutical, Inc. | $125 |
| ABBVIE INC. | $103 |
| Corium, LLC | $74 |
| SK Life Science, Inc. | $63 |
| Neurelis, Inc. | $57 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 403 | 77 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 286 | 65 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 154 | 49 | $0 |
Insurance plans in this area (ZIP 54914)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | WI | 90792 | Psychiatric diagnostic evaluation with medical services | 36 | 36 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI |
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