University of Wisconsin System Non Payroll

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL

Doing business as

Waisman Center TIES Clinic

Practice address

122 E Olin Ave Ste 255
Madison, WI 53713

Phone

(608) 265-9438

Fax

(608) 263-4681

NPI assigned

Apr 4, 2007

Last updated

Dec 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Mount

Title

Associate Dean

Phone

(608) 263-4938

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Waisman Center TIES Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 2

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

• University of Wisconsin System Non Payroll

  dba UW Health

  • Multi-Specialty Clinic/Center
  • Madison, WI
  • NPI 1346266319

  9133024888

  Same PAC ID
• University of Wisconsin System Non Payroll

  dba Board of Regents University of Wis System WI State Laboratory of Hygie

  • Clinical Medical Laboratory
  • Madison, WI
  • NPI 1669458386

  9133024888

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• University of Wisconsin System Non Payroll

  dba UW Health

  • Multi-Specialty Clinic/Center
  • Madison, WI
  • NPI 1346266319

  O20031204001102

  Same enrollment
• University of Wisconsin System Non Payroll

  dba Wausau Family Medicine

  • Multi-Specialty Clinic/Center
  • Wausau, WI
  • NPI 1487978839

  O20031204001102

  Same enrollment

Locations

Practitioners 210

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.

• Steven Singer, M.D.

  • Psychiatry Physician
  • Madison, WI
  • NPI 1598789331
  Medicare reassignment Care Compare group NPD
• Lauren Bern, M.D.

  • Geriatric Psychiatry Physician
  • Madison, WI
  • NPI 1184675266
  Medicare reassignment NPD
• Jade Arielle Anderson, M.D.

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1871941252
  NPD
• Gregory D Avey, M.D.

  • Neuroradiology Physician
  • Madison, WI
  • NPI 1881644813
  NPD
• Amy Baillies, SLP

  • Speech-Language Pathologist
  • Madison, WI
  • NPI 1023072667
  NPD
• Kathleen M Baus, MD

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1063480291
  NPD
• Donna G Blankenbaker, MD

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1558322065
  NPD
• David Alan Bluemke, M.D.

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1043276728
  NPD
• Valerie A Boll, NP

  • Nurse Practitioner
  • Madison, WI
  • NPI 1720049638
  NPD
• Zachary Stephen Borden, M.D.

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1750677290
  NPD
• Robert Kenneth Bour, M.D.

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1285892844
  NPD
• Anupama Gupta Brixey, M.D.

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1679619936
  NPD

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1184746828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E OLIN AVE STE 255",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131468",
            "telephone_number": "608-265-9438",
            "fax_number": "608-263-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E OLIN AVE STE 255",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53713",
            "telephone_number": "608-265-9438",
            "fax_number": "608-263-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "MOUNT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "ASSOCIATE DEAN",
        "authorized_official_telephone_number": "608-263-4938"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21252100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waisman Center TIES Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waisman Center TIES Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• University of Wisconsin Medical Foundation, Inc (UW Health Optical)
• University of Wisconsin Medical Foundation, Inc
• University of Wisconsin Student Health Services
• University of Wisconsin System Non Payroll (University Speech and Hearing Clinic)
• University of Wisconsin System Non Payroll
• University of Wisconsin System Non Payroll
• University of Wisconsin System Non Payroll (UW Health)
• University of Wisconsin System Non Payroll (Waisman Center)
• University of Wisconsin System Non Payroll (UW-Madison Vet Med Hospital Pharmacy)
• University of Wisconsin System Non Payroll (RMCM-UW Medical School)

• Adult Mental Health Clinic/Center in Madison, WI
• Providers in Madison, WI by specialty
• Adult Mental Health Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.