BADIEH WIDMER OTR
NPI 1114086881
Occupational Therapist in Random Lake, WI
About Badieh Widmer Otr NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BADIEH WIDMER OTR (NPI 1114086881) is an individual occupational therapist in Random Lake, Wisconsin, licensed in Wisconsin (3207-026) and active in the NPI registry since December 2006.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Badieh Widmer Otr is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Badieh Widmer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Scottsdale, AZ 85258
- Reassigned Medicare billing, Arizona enrollment
- 22 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
RANDOM LAKE, WI 53075
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Badieh Widmer's NPI number?
The NPI number for Badieh Widmer is 1114086881. It was assigned to this individual provider in the NPPES registry on December 8, 2006.
Where is Badieh Widmer located?
Badieh Widmer practices at N546 Schroeter Dr, Random Lake, WI 53075. The listed phone number is (920) 207-3550.
What is Badieh Widmer's specialty?
The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.
Is Badieh Widmer enrolled in Medicare?
Yes. Badieh Widmer is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Badieh Widmer's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Badieh Widmer reassigns Medicare benefits to Phoenix Mountain Therapy LLC (Scottsdale, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Badieh Widmer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Badieh Widmer was last updated on January 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.