Diana Nicole Carvajal, MD
Individual provider Active NPI Family Medicine Physician · Madison, WI
NPI 1043466030 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1043466030
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 84078 (WI)
- Practice address
- 1102 S Park St Ste 100
Madison, WI 53715-1708 - Phone
- (608) 263-3111
- NPI assigned
- Aug 11, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Community Health Centers Inc
Practice addresses (Care Compare)
1102 S Park St
Madison, WI 53715-1708
Phone (608) 263-3111
2202 S Park St
Madison, WI 53713-1916
Phone (608) 443-5480
3434 E Washington Ave
Madison, WI 53704-4155
Phone (608) 443-5480
Hospital & facility affiliations
- University of Wi Hospitals & Clinics Authority
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241018000994 | WI | Practitioner - Family Practice | 9133288970 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84078 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Centers, Inc. | Current |
Accepting new patients | |
| Access Community Health Centers, Inc. | Current |
Accepting new patients |
Locations
2202 S Park St
Madison, WI 53713
Phone (608) 443-5480
1102 S Park St
Madison, WI 53715
Phone (608) 263-3111
1102 S Park St
Ste 100
Madison, WI 53715
Phone (608) 263-3111
2901 W Beltline Hwy
Ste 120
Madison, WI 53713
Phone (608) 443-5500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 84078 | WI | Yes |
Addresses
Primary practice location
1102 S Park St Ste 100
Madison, WI 53715-1708
Mailing address
7974 Uw Health CT
Middleton, WI 53562-5531
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dcarvajal4940390@direct.uwhealth.org |
Other providers in Madison, WI
- Richard L Carter
- Carters Delivery Services LLC
- Patti I Cartier-Neely
- Elisabeth Cartwright
- Donald A Carufel-Wert
- Thomas Carvell
- Zachary Carwile
- Abigail A Cary
- Sherry L Casali
- Amanda Case
All providers in Madison, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.