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Robert John Booth

Counselor - Mental Health β€’ Appleton, WI

Active NPI 1831768258 Individual Practitioner Male Practitioner Accepts Medicare assignment Telehealth (some services)
Practice location in NPPES

2500 E Enterprise Ave Ste B
Appleton, WI 549138556

Call 9204168577 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2500 E Enterprise Ave Ste B

Appleton, WI 549138556

Telephone 9204168577
Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Nystrom And Associates Counseling Wi Sc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026

Graduation Year

2021

Years since graduation

5 years (graduated 2021)

CMS Doctors and Clinicians data list 2021 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

Telehealth (some services)

Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.

What this does not show: Telehealth (some services)

It does not mean all services are offered by telehealth, or that telehealth is covered by your plan.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Robert Booth has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Robert Booth as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Appleton and Wisconsin

73 active clinicians are listed under Counselor - Mental Health with a practice address in Appleton, WI (2,680 in Wisconsin).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Appleton

5.5% of these 73 clinicians have the CMS telehealth indicator.

6.8% of these 73 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-04-14
Counselor - Mental Health Primary Specialty

NUCC Taxonomy Code: 101YM0800X

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Wisconsin Department of Safety and Professional Services.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
42251300 (WI)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - MENTAL HEALTH COUNSELOR

Medicare Enrollment ID

I20231222001843

Enrollment State Jurisdiction

WI

PECOS Control ID

6608226238

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026

Nystrom And Associates Counseling Wi Sc

2500 E Enterprise Ave, Appleton, WI 549138556

Phone: 9204168577

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Heather Duzynski , APNP, RN

Nurse Practitioner - Psychiatric/Mental Health

NPI 1376317743

Advanced Practice Nurse Prescriber, Registered Nurse

Gabrielle Jochman , LCSW

Social Worker - Clinical

NPI 1407486541

Licensed Clinical Social Worker

Sarah Motacek , LCSW

Social Worker - Clinical

NPI 1184089864

Licensed Clinical Social Worker

Mary Stample , APNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1750096145

Advanced Practice Nurse Prescriber

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location April 14, 2023

Registered at 2500 E ENTERPRISE AVE STE B, APPLETON, WI 549138556 (Tel: 9204168577)

πŸ“
Updated Practice Location September 12, 2022

Registered at 333 N GREEN BAY RD, NEENAH, WI 549561954 (Tel: 9207202300)

βœ…
NPI Profile Active June 21, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 21, 2021

Registered at E7475 RAWHIDE RD, NEW LONDON, WI 549619025 (Tel: 8773009101)

πŸ“
Business Mailing Address (Initial Record) June 21, 2021

Registered at 1809 HICKORY LN, OSHKOSH, WI 549012510 (Tel: 8773009101)

πŸ‘€
Provider Name / Credentials (Initial Record) June 21, 2021

Recorded as ROBERT BOOTH

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 21, 2021

Counselor

🟒
Initial NPI Registration & Enumeration June 21, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1831768258
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 21, 2021
Last Update: April 14, 2023
Sole Proprietor: No

Mailing Address

1809 Hickory Ln

Oshkosh, WI 549012510

Phone: 8773009101

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.