NPIMap

Organization Active NPI

American Community Medical Center Inc.

  • Family Medicine Physician
  • Madison, WI
National Provider Identifier
1104127067
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43432-20 Issued in WI
Legal business name
AMERICAN COMMUNITY MEDICAL CENTER INC.
Practice address
1421 S Park St
Madison, WI 53715-2178
Phone
(608) 441-6888
Fax
(608) 441-6888
NPI assigned
Nov 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Dr. Yasmin Yusuf-Safavi, MDNPI 1588705032
Title
Medical Director
Phone
(608) 443-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 43432-20 WI Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 43432-20 WI
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 43432-20 WI
Clinic/Center 261Q00000X 43432-20 WI
Community Health Clinic/Center 261QC1500X 434322-020 WI
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 1744 WI

Addresses

Primary practice location

1421 S Park St
Madison, WI 53715-2178

Mailing address

1421 S Park St
Madison, WI 53715-2178
Phone (608) 441-6888

Other identifiers 2

IdentifierTypeStateIssuer
1104127067MedicaidWI
1588705032OtherWINPI

Other names 1

  • AC Medical Center or ACMC Other name

National Provider Directory

National Provider Directory

Locations

1421 S Park St
Madison, WI 53715
Phone (608) 441-6888

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1104127067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152178",
            "telephone_number": "608-441-6888",
            "fax_number": "608-441-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152178",
            "telephone_number": "608-441-6888",
            "fax_number": "608-441-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN COMMUNITY MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "YUSUF-SAFAVI",
        "authorized_official_first_name": "YASMIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "608-443-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "43432-20",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "43432-20",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "WI",
            "license": "43432-20",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "43432-20",
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "WI",
            "license": "434322-020",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104127067",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1588705032",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AC Medical Center or ACMC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.