IAN ROUDEBUSH
NPI 1710606520
Counselor - Professional in Brown Deer, WI
About Ian Roudebush NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IAN ROUDEBUSH (NPI 1710606520) is an individual professional provider in Brown Deer, Wisconsin and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ian Roudebush is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ian Roudebush reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Brown Deer, WI 53209
- Reassigned Medicare billing, Wisconsin enrollment
- 23 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MILWAUKEE, WI 53209
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 Ian Roudebush's NPI number?
The NPI number for Ian Roudebush is 1710606520. It was assigned to this individual provider in the NPPES registry on August 24, 2022.
Where is Ian Roudebush located?
Ian Roudebush practices at 3900 W Brown Deer Rd Ste 200, Brown Deer, WI 53209. The listed phone number is (414) 540-2170.
What is Ian Roudebush's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Ian Roudebush enrolled in Medicare?
Yes. Ian Roudebush is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ian Roudebush's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ian Roudebush reassigns Medicare benefits to Shorehaven Behavioral Health Inc (Brown Deer, 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 Ian Roudebush's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ian Roudebush accept?
Health plans from Network Health and UnitedHealthcare list Ian Roudebush 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 Ian Roudebush was last updated on August 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Ian Roudebush · NPI 1710606520
Professional provider in Brown Deer, Wisconsin. Individual provider, active in the CMS NPPES registry since August 24, 2022.
## Identity
- **NPI:** 1710606520 (Entity type: Individual)
- **Enumerated:** August 24, 2022
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Sole proprietor:** No
## Practice location
- **Address:** 3900 W BROWN DEER RD STE 200, Brown Deer, WI 53209-1220
- **Phone:** (414) 540-2170
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Shorehaven Behavioral Health Inc (NPI 1891887055, Brown Deer, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** August 24, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1710606520) · Data from the CMS NPPES public registry.