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DERECK WOLFGRAM LCSW
NPI 1174093744
Social Worker - Clinical in Oconomowoc, WI

Active since November 27, 2018PECOS Enrolled
1230 CORPORATE CENTER DR STE 100, OCONOMOWOC, WI 53066(262) 999-3495 Get Directions Write a Review

NPPES record last updated: February 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 12, 2020, Nov 27, 2018 (2 updates tracked since 2018).

About Dereck Wolfgram Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERECK WOLFGRAM LCSW (NPI 1174093744) is an individual clinical provider in Oconomowoc, Wisconsin, licensed in Wisconsin (9365-123) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174093744
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameDERECK WOLFGRAMCredential: LCSW
Location Address1230 CORPORATE CENTER DR STE 100Oconomowoc, WI 53066-4883
Mailing Address1230 Corporate Center Dr Ste 100Oconomowoc, WI 53066-4883 · (262) 999-3495
Phone(262) 999-3495
Sole ProprietorYes
Enumeration DateNovember 27, 2018
Last NPPES UpdateFebruary 20, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 20, 2026
✔ NPI 1174093744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in WI · 9365-123
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1230 CORPORATE CENTER DR STE 100, Oconomowoc, WI 53066
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Dean Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dereck Wolfgram Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Dereck Wolfgram reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cornerstone Counseling Services, Inc
18 mi
Mental Health
16535 W BLUEMOUND RD, SUITE 200
Brookfield, WI 53005
  • Reassigned Medicare billing, Wisconsin enrollment
  • 556 clinicians in this Medicare group
NPI 1033127246 (262) 789-1191

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $53.90 – $163.24
Typical copayment $0.00 (range $13.47 – $40.81)
Most-billed visit code NA
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CALEY DELORIS MAMEROW LPC
Counselor (Professional)
1230 CORPORATE CENTER DR STE 100
OCONOMOWOC, WI 53066
Waukesha County (262) 789-1191
BETH ANN WUERL LCSW
Social Worker (Clinical)
1230 CORPORATE CENTER DR STE 100
OCONOMOWOC, WI 53066
Waukesha County (262) 189-1191
ELIZABETH ARNDORFER LPC
Counselor (Professional)
1230 CORPORATE CENTER DR STE 100
OCONOMOWOC, WI 53066
Waukesha County (262) 999-3495
MR. AUGUST VIEGUT LPC
Counselor (Professional)
1230 CORPORATE CENTER DR STE 100
OCONOMOWOC, WI 53066
Waukesha County (715) 305-6688
JOSHUA TACKES L.P.C.
Counselor (Professional)
1230 CORPORATE CENTER DR STE 100
OCONOMOWOC, WI 53066
Waukesha County (262) 789-1191

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 Dereck Wolfgram's NPI number?

The NPI number for Dereck Wolfgram is 1174093744. It was assigned to this individual provider in the NPPES registry on November 27, 2018.

Where is Dereck Wolfgram located?

Dereck Wolfgram practices at 1230 Corporate Center Dr Ste 100, Oconomowoc, WI 53066. The listed phone number is (262) 999-3495.

What is Dereck Wolfgram's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Dereck Wolfgram enrolled in Medicare?

Yes. Dereck Wolfgram is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Dereck Wolfgram's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dereck Wolfgram reassigns Medicare benefits to Cornerstone Counseling Services, Inc (Brookfield, WI). 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 Dereck Wolfgram's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dereck Wolfgram accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Dean Health Plan, Network Health and Quartz list Dereck Wolfgram as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dereck Wolfgram was last updated on February 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.