RUSS KINKADE PSY D SC
NPI 1992195192
Clinic/Center in Mount Pleasant, WI
About Russ Kinkade Psy D Sc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RUSS KINKADE PSY D SC (NPI 1992195192) is a healthcare organization registered as a clinic/center in Mount Pleasant, Wisconsin and active in the NPI registry since January 2015. The organization maintains a secondary practice location in Pewaukee and lists Russell William Kinkade, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Russ Kinkade Psy D Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Russ Kinkade Psy D Sc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Racine, WI 53406
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Russ Kinkade Psy D Sc's NPI number?
The NPI number for Russ Kinkade Psy D Sc is 1992195192. It was assigned to this organization in the NPPES registry on January 27, 2015.
Where is Russ Kinkade Psy D Sc located?
Russ Kinkade Psy D Sc is located at 6214 Washington Ave C-10, Mount Pleasant, WI 53406. The listed phone number is (262) 989-5228.
What is Russ Kinkade Psy D Sc's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Russ Kinkade Psy D Sc enrolled in Medicare?
Yes. Russ Kinkade Psy D Sc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Russ Kinkade Psy D Sc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Russ Kinkade Psy D Sc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Russ Kinkade Psy D Sc was last updated on August 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Russ Kinkade Psy D Sc · NPI 1992195192
Clinic/Center organization in Mount Pleasant, Wisconsin. Organization record, active in the CMS NPPES registry since January 27, 2015.
## Identity
- **NPI:** 1992195192 (Entity type: Organization)
- **Enumerated:** January 27, 2015
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Russell Kinkade, PRESIDENT
## Practice location
- **Address:** 6214 WASHINGTON AVE, C-10, Mount Pleasant, WI 53406-3986
- **Phone:** (262) 989-5228 · **Fax:** (262) 878-9285
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 1, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1992195192) · Data from the CMS NPPES public registry.