NPIMap

Organization Active NPI

University of Wisconsin Medical Foundation Inc

  • Durable Medical Equipment & Medical Supplies
  • Madison, WI
National Provider Identifier
1174965008
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC
Practice address
1102 S Park St
2ND Floor
Madison, WI 53715-1708
Phone
(608) 287-5899
NPI assigned
Jul 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Authorized official

Name
Robert Flannery
Title
Cao & Cfo
Phone
(608) 821-4223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1102 S Park St
2ND Floor
Madison, WI 53715-1708

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531
Phone (608) 829-5485

Other names 1

  • UW Health 1102 S Park Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140502001357 WI DME Supplier - Multi-Specialty - Physician 6608785464 Practice locations: Madison, WI

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2238047Uw Health 1102 S Park St Clinic1102 S Park St, Madison, WI 53715Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Univ of Wisconsin Medical26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Uw Health Care DirectMiddleton, WI, CCN 527220 Home health agency 5% Or Greater Indirect Ownership Interest (50%) Jul 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2,537

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

View all 2,537

NPI Registry JSON

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467849600000",
    "number": "1174965008",
    "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",
            "telephone_number": "608-829-5485",
            "fax_number": "608-833-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S PARK ST",
            "address_2": "2ND FLOOR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151708",
            "telephone_number": "608-287-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-19",
        "last_updated": "2016-07-07",
        "status": "A",
        "authorized_official_last_name": "FLANNERY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CAO & CFO",
        "authorized_official_telephone_number": "608-821-4223"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UW Health 1102 S Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.