Individual provider Active NPI

Sandra K Roof, NP

  • Family Medicine Physician
  • Madison, WI
National Provider Identifier
1043237910
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
733-033 Issued in WI
Practice address
4660 S Biltmore LN
Madison, WI 53718-2104
Phone
(608) 284-8654
NPI assigned
Jul 16, 2006
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 733-033 WI Primary

Addresses

Primary practice location

4660 S Biltmore LN
Madison, WI 53718-2104

Mailing address

1687 Jackjay Dr
Sun Prairie, WI 53590-8302
Phone (608) 279-3951

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000609 WI Practitioner - Nurse Practitioner 2466481015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisconsin Hyperbaric Oxygen LLCGroup PAC ID 6305256090, 3 clinicians

Practice addresses (Care Compare)

4660 S Biltmore LN
Madison, WI 53718-2104
Phone (608) 284-8654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
733-033WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Hyperbaric Oxygen LLC CurrentSince May 1, 2023 Accepting new patients
Watertown Physician Practices LLC CurrentSince Sep 1, 2015 Accepting new patients
Watertown Physician Practices LLC Family Medicine Current Accepting new patients

Locations

4660 S Biltmore Ln
Madison, WI 53718
Phone (608) 284-8654

111 Anna St
Waterloo, WI 53594
Phone (920) 478-3776

123 Hospital Dr
Ste 206
Watertown, WI 53098
Phone (920) 262-4698

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1043237910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1687 JACKJAY DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535908302",
            "telephone_number": "608-279-3951",
            "fax_number": "855-374-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S BILTMORE LN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182104",
            "telephone_number": "608-284-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOF",
        "first_name": "SANDRA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "733-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.