Individual provider Active NPI

Andrew Livermore, MD

  • Orthopaedic Surgery Physician
  • Madison, WI
National Provider Identifier
1225472822
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
63149 Issued in WI
Practice address
1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone
(608) 252-8000
Fax
(608) 288-6490
NPI assigned
Apr 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 10765982-1205 UT
Orthopaedic Surgery Physician 207X00000X 63149 WI Primary

Addresses

Primary practice location

1211 Fish Hatchery Rd
Madison, WI 53715-1909

Mailing address

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

Other identifiers 1

IdentifierTypeStateIssuer
1225472822MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address alivermroe316351@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, 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
I20181010003529 UT Practitioner - Orthopedic Surgery 6507089240 Reassigns benefits to 1 organization
I20190919002038 WI Practitioner - Orthopedic Surgery 6507089240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Wisconsin School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement75
Knee replacement100
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Sep 16, 2019 Accepting new patients
University of Utah Adult Services CurrentSince Jul 1, 2018 Accepting new patients
University of Utah Adult Services CurrentSince Jul 1, 2018 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Dean Health Systems, Inc CurrentSince Sep 16, 2019 Accepting new patients

Locations

590 S Wakara Way
Slc, UT 84108
Phone (801) 587-7005

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1626 Tuttle St
Baraboo, WI 53913
Phone (608) 355-2033

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: alivermroe316351@direct-ehr-ssmhc.com

Organizations & group practices 5

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

Hospital & facility affiliations 6

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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1225472822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-288-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-288-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVERMORE",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-25",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "10765982-1205",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "63149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225472822",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1211 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alivermroe316351@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "alivermroe316351@direct-ehr-ssmhc.com",
            "address_1": "1211 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.