NPIMap

Individual provider Active NPI

Carolyn Jean Gullick, PA-C

  • Medical Physician Assistant
  • Madison, WI
National Provider Identifier
1073964342
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3762-23 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-1830
Phone
(608) 263-5442
Fax
(608) 265-1753
NPI assigned
Jun 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3762-23 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-1830

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgullick5951284@direct.uwhealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160808001878 WI Practitioner - Physician Assistant 3577857960 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sauk Prairie Healthcare IncGroup PAC ID 8224948054, 122 clinicians

Practice addresses (Care Compare)

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-7574

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 7, 2024 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Jan 10, 2018 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Sauk Prairie Healthcare Inc CurrentSince Aug 23, 2023 Accepting new patients
Sauk Prairie Healthcare, Inc. CurrentSince Aug 23, 2023 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 7, 2024 Accepting new patients
Reedsburg Area Medical Center Inc CurrentSince Jan 10, 2018 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients
Sauk Prairie Healthcare Inc Past Accepting new patients

Locations

4621 Eastpark Blvd
Madison, WI 53718
Phone (608) 914-0100

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

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

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

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

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

250 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2431

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

Interoperability endpoints

  • Direct secure messaging: cgullick5951284@direct.uwhealth.org
  • Direct secure messaging: cmcfarland261730@direct-ehr-ssmhc.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 12

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 4

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": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1073964342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537921830",
            "telephone_number": "608-263-5442",
            "fax_number": "608-265-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLICK",
        "first_name": "CAROLYN",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "3762-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgullick5951284@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "600 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537921830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.