Meghan D Fondow, DR
Individual provider Active NPI Psychologist · Madison, WI
NPI 1265680490 · NPPES record last updated Feb 8, 2021
Key facts
- NPI
- 1265680490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 2746-57 (WI)
- Practice address
- 3434 E Washington Ave
Madison, WI 53704-4155 - Phone
- (608) 443-5550
- Fax
- (608) 443-5553
- NPI assigned
- Aug 29, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Community Health Centers Inc
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120508000366 | WI | Practitioner - Clinical Psychologist | 1557523560 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Centers, Inc. | Current |
Accepting new patients | |
| Access Community Health Centers, Inc. | Current |
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
- mfondow34801@direct.uwhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2746-57 | WI | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mfondow34801@direct.uwhealth.org |
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.