Individual provider Active NPI

Meghan D Fondow, DR

  • Psychologist
  • Madison, WI
National Provider Identifier
1265680490
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2746-57 Issued in WI
Practice address
3434 E Washington Ave
Madison, WI 53704-4155
Phone
(608) 443-5550
Fax
(608) 443-5553
NPI assigned
Aug 29, 2008
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2746-57 WI Primary

Addresses

Primary practice location

3434 E Washington Ave
Madison, WI 53704-4155

Mailing address

3434 E Washington Ave
Madison, WI 53704-4155
Phone (608) 443-5550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mfondow34801@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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120508000366 WI Practitioner - Clinical Psychologist 1557523560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1102 S Park St
Madison, WI 53715-1708
Phone (608) 263-3111

2202 S Park St
Madison, WI 53713-1916
Phone (608) 443-5480

3434 E Washington Ave
Madison, WI 53704-4155
Phone (608) 443-5480

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2746-57WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Centers, Inc. CurrentSince Mar 1, 2012 Accepting new patients
Access Community Health Centers, Inc. CurrentSince Mar 1, 2012 Accepting new patients

Locations

2202 S Park St
Madison, WI 53713
Phone (608) 443-5480

2901 W Beltline Hwy
Ste 120
Madison, WI 53713
Phone (608) 443-5500

3434 E Washington Ave
Madison, WI 53704
Phone (608) 443-5480

Interoperability endpoints

  • Direct secure messaging: mfondow34801@direct.uwhealth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1265680490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044155",
            "telephone_number": "608-443-5550",
            "fax_number": "608-443-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044155",
            "telephone_number": "608-443-5550",
            "fax_number": "608-443-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONDOW",
        "first_name": "MEGHAN",
        "middle_name": "D",
        "credential": "DR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-29",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2746-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfondow34801@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "3434 E Washington Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537044155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.