NPIMap

Organization Active NPI

Madison Area Renal Specialists, SC

  • Nephrology Physician
  • Fitchburg, WI
National Provider Identifier
1104834894
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MADISON AREA RENAL SPECIALISTS, SC
Practice address
2840 Index Rd
Fitchburg, WI 53713-3117
Phone
(608) 229-7221
Fax
(608) 826-2710
NPI assigned
Aug 4, 2006
Last updated
Apr 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Authorized official

Name
Christoph Eggert, MDNPI 1598738247
Title
MD
Phone
(608) 229-7221

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

2840 Index Rd
Fitchburg, WI 53713-3117

Mailing address

2840 Index Rd
Fitchburg, WI 53713-3117
Phone (608) 229-7221

Other identifiers 1

IdentifierTypeStateIssuer
21271100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000585 WI Part B Supplier - Clinic/Group Practice 8628979432 Receives reassigned benefits from 8 practitioners
Practice locations: Sun Prairie, WI; Stoughton, WI; Madison, WI; Janesville, WI; Fitchburg, WI; Baraboo, WI; Dodgeville, WI

National Provider Directory

National Provider Directory

Locations

1600 Jefferson St
#1673
Baraboo, WI 53913

1600 Jefferson St
Ste 200
Baraboo, WI 53913
Phone (608) 355-1860

1626 Tuttle St
Ste 3
Baraboo, WI 53913
Phone (608) 229-7221

2840 Index Rd
Fitchburg, WI 53713
Phone (608) 229-7221

1407 Creston Park Dr
Janesville, WI 53545
Phone (608) 752-6362

1407 Creston Park Dr
Ste A
Janesville, WI 53545

3200 E Racine St
#2343
Janesville, WI 53546

202 S Park St
#1507
Madison, WI 53715

436 Sunrise Dr
Spring Green, WI 53588
Phone (608) 588-2502

140 E Adams St
Wisconsin Dells, WI 53965
Phone (608) 253-4677

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1104834894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 INDEX RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537133117",
            "telephone_number": "608-229-7221",
            "fax_number": "608-826-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 INDEX RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537133117",
            "telephone_number": "608-229-7221",
            "fax_number": "608-826-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON AREA RENAL SPECIALISTS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "EGGERT",
        "authorized_official_first_name": "CHRISTOPH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "608-229-7221",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21271100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.