Individual provider Active NPI

Eliza A. Bennett, M.D.

  • Obstetrics & Gynecology Physician
  • Madison, WI
National Provider Identifier
1003852161
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
51413-20 Issued in WI
Practice address
20 S Park St
OB/GYN Clinic
Madison, WI 53715-1348
Phone
(608) 287-2830
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 51413-20 WI Primary

Addresses

Primary practice location

20 S Park St
OB/GYN Clinic
Madison, WI 53715-1348

Mailing address

1 South Park Suite 555
University of Wisconsin Department of OB/GYN
Madison, WI 53715-1349
Phone (608) 287-2494

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebennett20589@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927000291 WI Practitioner - Obstetrics/Gynecology 3971629056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Kentucky College of Dentistry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

137 S Main St
Oregon, WI 53575-1534
Phone (608) 835-5588

20 S Park St
Madison, WI 53715-1348
Phone (608) 287-2076

202 S Park St
Madison, WI 53715-1507
Phone (608) 287-2050

2402 Winnebago St
Madison, WI 53704-5341
Phone (608) 287-2770

2977 County Hwy CX
Portage, WI 53901-9271
Phone (608) 287-2770

451 Junction Rd
Madison, WI 53717-2656
Phone (608) 265-7700

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51413-20WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Aug 1, 2010 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Aug 1, 2010 Accepting new patients
Planned Parenthood of Wisconsin Past Accepting new patients
Planned Parenthood of Wisconsin Past Accepting new patients
Planned Parenthood of Wisconsin Past Accepting new patients

Locations

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

20 S Park St
Madison, WI 53715
Phone (608) 287-2090

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Networks

  • IL HMO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • IL PPO Downstate

Interoperability endpoints

  • Direct secure messaging: eliza.bennett.p1@direct.ppwi.nextgenshare.com
  • Direct secure messaging: ebennett20589@direct.uwhealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1003852161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SOUTH PARK SUITE 555",
            "address_2": "UNIVERSITY OF WISCONSIN DEPARTMENT OF OB/GYN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151349",
            "telephone_number": "608-287-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S PARK ST",
            "address_2": "OB/GYN CLINIC",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151348",
            "telephone_number": "608-287-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ELIZA",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "51413-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebennett20589@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "20 S Park St",
            "address_2": "Ob/Gyn Clinic",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.