Individual provider Active NPI

Connie S. Zhong

  • Dermatology Physician
  • Madison, WI
National Provider Identifier
1194352138
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
86061 Issued in WI
Practice address
4621 Eastpark Blvd
Madison, WI 53718-2000
Phone
(608) 914-0400
NPI assigned
Mar 26, 2020
Last updated
Oct 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 1018824 MA
Dermatology Physician 207N00000X 86061 WI Primary

Addresses

Primary practice location

4621 Eastpark Blvd
Madison, WI 53718-2000

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240605000577 MA Practitioner - Dermatology 8820530967 Reassigns benefits to 1 organization
I20251023003037 WI Practitioner - Dermatology 8820530967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

221 Longwood Ave
Boston, MA 02115-5804
Phone (617) 732-5500

4621 Eastpark Blvd
Madison, WI 53718-2000
Phone (608) 914-0100

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

850 Boylston St
Chestnut Hill, MA 02467-2477
Phone (617) 732-5500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of tissue1-10
Removal of skin lesions241
Removal or shaving of skin growth1-10
Skin biopsy105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1018824MAMDDermatology Physician
86061WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Dermatology CurrentSince Jul 1, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 13, 2025 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 13, 2025 Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

75 Francis St
Boston, MA 02115

4621 Eastpark Blvd
Madison, WI 53718
Phone (608) 914-0100

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1194352138",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 EASTPARK BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182000",
            "telephone_number": "608-914-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHONG",
        "first_name": "CONNIE",
        "middle_name": "S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "1018824",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "86061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.