Individual provider Active NPI

Stacy Ranguette, PA

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1235546557
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3382-23 Issued in WI
Practice address
4602 Eastpark Blvd
Madison, WI 53718
Phone
(608) 263-7540
NPI assigned
Jul 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3382-23 WI Primary

Addresses

Primary practice location

4602 Eastpark Blvd
Madison, WI 53718

Mailing address

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

Other names 1

  • Stacy Wittkopp Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sranguette941927@direct.uwhealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905002206 WI Practitioner - Physician Assistant 8224256185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4602 Eastpark Blvd
Madison, WI 53718-2002
Phone (608) 440-6400

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 9, 2018 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 9, 2018 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Aug 4, 2014 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

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

4602 Eastpark Blvd
Madison, WI 53718
Phone (608) 263-7540

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

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

Interoperability endpoints

  • Direct secure messaging: jfricke673431@direct.uwhealth.org

Organizations & group practices 4

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 4

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": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1235546557",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 EASTPARK BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53718",
            "telephone_number": "608-263-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGUETTE",
        "first_name": "STACY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3382-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sranguette941927@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "4602 Eastpark Blvd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "WITTKOPP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.