Active NPI
Harrison Chase Gottlich
- Urology Physician
- Madison, WI
National Provider Identifier
1144070913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 101110-851
- Practice address
- 600 Highland Ave
Madison, WI 53792-1465 - Phone
- (608) 263-6400
- NPI assigned
- Mar 25, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 101110-851 | WI | Primary |
Addresses
Primary practice location
600 Highland Ave
Madison, WI 53792-1465
Mailing address
749 University Row Ste 200
Madison, WI 53705-1465
Phone (608) 263-6400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240703001152 | WI | Order and Referring Only - Urology | 0446794283 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1144070913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "749 UNIVERSITY ROW STE 200",
"city": "MADISON",
"state": "WI",
"postal_code": "537051465",
"telephone_number": "608-263-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537921465",
"telephone_number": "608-263-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTLICH",
"first_name": "HARRISON",
"middle_name": "CHASE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-25",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WI",
"license": "101110-851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.