NPIMap

Organization Active NPI

University of Wisconsin System Non Payroll

  • Clinical Medical Laboratory
  • Madison, WI
National Provider Identifier
1124155403
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
52D0662277CLIA Issued in WI
Legal business name
UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Practice address
1500 Highland Ave
Waisman Center RM 362
Madison, WI 53705-2280
Phone
(608) 263-5993
Fax
(608) 263-0530
NPI assigned
Feb 27, 2007
Last updated
Nov 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Authorized official

Name
Jon A Wolff, MD
Title
Director
Phone
(608) 263-5993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 52D0662277CLIA WI Primary

Addresses

Primary practice location

1500 Highland Ave
Waisman Center RM 362
Madison, WI 53705-2280

Mailing address

1500 Highland Ave
Waisman Center RM 362
Madison, WI 53705-2280
Phone (608) 263-5993

Other identifiers 2

IdentifierTypeStateIssuer
000089834OtherWIMEDICARE
32907000MedicaidWI

Other names 1

  • Univ of WI System Biochemical Genetics Lab Other name

National Provider Directory

National Provider Directory
Tax ID family
Center for Communicativ25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

1500 Highland Ave
Rm 362
Madison, WI 53705
Phone (608) 263-5993

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1124155403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 HIGHLAND AVE",
            "address_2": "WAISMAN CENTER RM 362",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052280",
            "telephone_number": "608-263-5993",
            "fax_number": "608-263-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HIGHLAND AVE",
            "address_2": "WAISMAN CENTER RM 362",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052280",
            "telephone_number": "608-263-5993",
            "fax_number": "608-263-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "608-263-5993",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D0662277CLIA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "000089834",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32907000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Univ of WI System Biochemical Genetics Lab",
            "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 Nov 27, 2024; 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.