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BRIAN L BOOMGARDEN MS CADC
NPI 1871510677
Counselor - Mental Health in Manitowoc, WI

Active since July 16, 2006PECOS EnrolledAccepts Medicare Assignment
339 REED AVE, MANITOWOC, WI 54220(920) 320-8600(920) 320-8662 Get Directions Write a Review

NPPES record last updated: June 3, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Brian L Boomgarden Ms Cadc NPPES

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

BRIAN L BOOMGARDEN MS CADC (NPI 1871510677) is an individual mental health provider in Manitowoc, Wisconsin, licensed in Wisconsin (2898-123) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1988).

NPPES Registry Identity

NPI1871510677
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameBRIAN L BOOMGARDENCredential: MS CADC
Location Address339 REED AVEManitowoc, WI 54220-2020
Mailing AddressPo Box 2290Manitowoc, WI 54221-2290 · (920) 320-8600 · Fax (920) 320-8662
Phone(920) 320-8600
Fax(920) 320-8662
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateJuly 16, 2006
Last NPPES UpdateJune 3, 2008
✔ NPI 1871510677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WI · 2898-123
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 11165 (WI)
339 REED AVE, Manitowoc, WI 54220
Open in Google Maps ↗

Other Identifiers 3

Other13647Network Health Plan
Other390806395Cigna
Medicaid39647200WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan, HealthPartners 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 and accepts Medicare assignment

Brian L Boomgarden Ms Cadc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355784372
PECOS Enrollment IDI20240207000779
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 Brian Boomgarden reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Froedtert Manitowoc Medical Group, LLC
1.8 mi
Multi-Specialty
2300 WESTERN AVE
Manitowoc, WI 54220
  • Reassigned Medicare billing, Wisconsin enrollment
  • 350 clinicians in this Medicare group
NPI 1437829975 (920) 320-2436

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 15

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

MICHAEL G ADERMAN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
339 REED AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8600
MARIANNE E WEBERS MSW
Social Worker (Clinical)
339 REED AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8600
BRENDA STALLBAUM APNP
Nurse Practitioner (Psychiatric/Mental Health)
339 REED AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8600
RACHEL GORDON LPC, CSAC, CAS
Counselor (Mental Health)
339 REED AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8600
MARY S CHRISTENSEN MSW
Social Worker (Clinical)
339 REED AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8600
LEE A WERNER NP
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
339 REED AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8600
EVAN MEYER LPC
Counselor (Professional)
339 REED AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8600
OLIVIA C. ALEXANDER MA, LPC
Counselor (Professional)
339 REED AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8600

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 Brian Boomgarden's NPI number?

The NPI number for Brian Boomgarden is 1871510677. It was assigned to this individual provider in the NPPES registry on July 16, 2006.

Where is Brian Boomgarden located?

Brian Boomgarden practices at 339 Reed Ave, Manitowoc, WI 54220. The listed phone number is (920) 320-8600.

What is Brian Boomgarden's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Brian Boomgarden enrolled in Medicare?

Yes. Brian Boomgarden is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Brian Boomgarden's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brian Boomgarden reassigns Medicare benefits to Froedtert Manitowoc Medical Group, LLC (Manitowoc, 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 Brian Boomgarden's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brian Boomgarden accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, HealthPartners and Network Health list Brian Boomgarden 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 Brian Boomgarden was last updated on June 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.