MBH TELEHEALTH
NPI 1205068616
Clinic/Center - Mental Health (Including Community Mental Health Center) in Milwaukee, WI
NPI Status: Active since August 18, 2009
Contact Information
3365 S 103RD ST
MILWAUKEE, WI
ZIP 53227
Phone: (414) 228-4800
Fax: (262) 432-9004
- Organization
- Clinic/Center
- Mental Health (Including Community Menta...
- Accepts Insurance
- CLIA Number: 52D0389255
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-31-2027
About MBH TELEHEALTH
This page provides the complete NPI Profile along with additional information for Mbh Telehealth, a provider established in Milwaukee, Wisconsin operating as a Clinic/center, focusing in mental health (including community mental health center) . The healthcare provider is registered in the NPI registry with number 1205068616 assigned on August 2009. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Mbh Telehealth operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Mbh Telehealth. The authorized official of this NPI record is Dr. Smriti Khare M.d. (President)
- NPI
- 1205068616
- Provider Legal Name
- CHILDREN'S MEDICAL GROUP
- Other Organization Name
- MBH TELEHEALTH
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3365 S 103RD ST MILWAUKEE, WI 53227
- Location Phone
- (414) 228-4800
- Location Fax
- (262) 432-9004
- Mailing Address
- 9000 W WISCONSIN AVE # MS 958 MILWAUKEE, WI 53226
- Mailing Phone
- (414) 266-7615
- Mailing Fax
- (262) 432-9004
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 08-18-2009
- Last Update Date
- 02-17-2023
- Code Navigator
Location Map
Secondary Locations
- 1655 W Mequon Rd
Mequon, WI 53092
(414) 228-4800 - 4855 S Moorland Rd Ste 150
New Berlin, WI 53151
(414) 228-4800 - 7322 W Rawson Ave
Franklin, WI 53132
(414) 228-4800 - 2561 N 29th St
Milwaukee, WI 53210
(414) 228-4800 - 4655 N Port Washington Rd Ste 200
Glendale, WI 53212
(414) 228-4800 - 5433 W Fond Du Lac Ave
Milwaukee, WI 53216
(414) 228-4800
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Mental Health (Including Community Mental Health Center)
- Taxonomy Code
- 261QM0801X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | |
| 3 | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | |
| 4 | 2080P0006X | Allopathic & Osteopathic Physicians | Pediatrics |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
- CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
- CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1205068616 | MEDICAID (05) | WI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0389255
- Facility Type
- Physician Office
- Certificate Effective Date
- September 01, 2025
- Certificate Expiration Date
- August 31, 2027
- Laboratory Director
- DR. STANLEY LO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mbh Telehealth to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for MBH TELEHEALTH
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1205068616, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MILWAUKEE, WI 53227
MILWAUKEE, WI 53227
MILWAUKEE, WI 53227
MILWAUKEE, WI 53227
MILWAUKEE, WI 53227
MILWAUKEE, WI 53227
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205068616, enumerated as an "organization" on August 18, 2009.
The provider is located at 3365 S 103RD ST MILWAUKEE, WI 53227 and the phone number is (414) 228-4800.
Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource. Please consult your insurance carrier or call the provider to verify.
