1. Home
  2. Directory
  3. Wisconsin
  4. Green Bay
  5. Counselor
  6. NPI Profile

MASON E VANROSSUM LPC
NPI 1881433506
Counselor - Professional in Green Bay, WI

Active since May 22, 2024PECOS EnrolledAccepts Medicare Assignment
480 PILGRIM WAY # 1300-A, GREEN BAY, WI 54304(920) 610-5119(920) 610-5120 Get Directions Write a Review

NPPES record last updated: November 26, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 26, 2025, Aug 4, 2025, Jun 26, 2024 (3 updates tracked since 2024).

About Mason E Vanrossum Lpc NPPES

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

MASON E VANROSSUM LPC (NPI 1881433506) is an individual professional provider in Green Bay, Wisconsin, licensed in Wisconsin (11795) and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1881433506
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMASON E VANROSSUMCredential: LPC
Location Address480 PILGRIM WAY # 1300-AGreen Bay, WI 54304-5280
Mailing Address1900 Silver Lake Rd Nw Ste 110New Brighton, MN 55112-1789 · (651) 628-9566 · Fax (651) 628-0411
Phone(920) 610-5119
Fax(920) 610-5120
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMay 22, 2024
Last NPPES UpdateNovember 26, 20253 updates tracked since enumeration
NPPES CertifiedNovember 26, 2025
✔ NPI 1881433506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 11795
Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 7475-226 (WI)
480 PILGRIM WAY # 1300-A, Green Bay, WI 54304
Open in Google Maps ↗

Other Identifiers 1

Medicaid100277298WI

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

Mason E Vanrossum Lpc 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 ID8123531829
PECOS Enrollment IDI20250626003547
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 Mason Vanrossum reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Nystrom & Associates Counseling Wi., S.C.
166 mi
Mental Health (Including Community Mental Health Center)
201 MAIN ST STE 500
La Crosse, WI 54601
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Nystrom & Associates Counseling Wi Sc
  • 133 clinicians in this Medicare group
NPI 1659977866 (651) 379-1750

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 11

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

MRS. TRICIA ANN KERKER LPC
Counselor (Professional)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
HOLLIE C SMET LPC
Counselor (Professional)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
DR. KIMBERLY K WALKER-DANIELS DNP-PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
MISS KERRY A TALBERT NP
Nurse Practitioner (Psychiatric/Mental Health)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
STEPHANIE M KREGEL-FORBES MSE, LPC
Counselor (Professional)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
ABIGAIL RUSSELL LCSW
Social Worker (Clinical)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
AUTUMN MARIE SCHLEIS LPC
Counselor (Professional)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119
MS. LAUREN ELIZABETH GIDLEY MSE, LPC, SAC-IT
Counselor (Mental Health)
480 PILGRIM WAY # 1300-A
GREEN BAY, WI 54304
Brown County (920) 610-5119

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 Mason Vanrossum's NPI number?

The NPI number for Mason Vanrossum is 1881433506. It was assigned to this individual provider in the NPPES registry on May 22, 2024.

Where is Mason Vanrossum located?

Mason Vanrossum practices at 480 Pilgrim Way # 1300-A, Green Bay, WI 54304. The listed phone number is (920) 610-5119.

What is Mason Vanrossum's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Mason Vanrossum enrolled in Medicare?

Yes. Mason Vanrossum 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 Mason Vanrossum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mason Vanrossum reassigns Medicare benefits to Nystrom & Associates Counseling Wi., S.C. (La Crosse, 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 Mason Vanrossum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mason Vanrossum accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, HealthPartners, Quartz and Security Health Plan and 1 other insurer list Mason Vanrossum 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 Mason Vanrossum was last updated on November 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.