Kristin Maureen Ebert, MD

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

75861 Issued in WI

Practice address

1675 Highland Ave
Madison, WI 53792-5703

Phone

(608) 263-6420

Fax

(608) 890-9745

NPI assigned

Mar 16, 2014

Last updated

Oct 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Kristin Maureen Fraleigh Former name

Medicare fee-for-service enrollment

Enrolled in OH, 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kebert1022501@direct.unitypoint.org
• Direct secure messaging: kristin.ebert@marshfieldclinichealthsystem.cernerdirect.com

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment NPD
• University of Wisconsin Medical Foundation, Inc

  • Multi-Specialty Clinic/Center
  • Middleton, WI
  • NPI 1598784555
  Medicare reassignment NPD
• Children's Surgical Associates, Corporation

  • Pediatric Surgery Physician
  • Columbus, OH
  • NPI 1417905324
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Aurora Medical Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1659599157
  NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health La Crosse Hospital

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Eau Claire Cancer Center

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Ladysmith

  • Critical Access Hospital
  • Ladysmith, WI
  • NPI 1952890873
  NPD

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

{
    "created_epoch": "1394928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1275959199",
    "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": "1675 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537925703",
            "telephone_number": "608-263-6420",
            "fax_number": "608-890-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "KRISTIN",
        "middle_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-16",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "75861",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "WI",
            "license": "75861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0395567",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100182252",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-CGS",
            "identifier": "H695240",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "FRALEIGH",
            "middle_name": "MAUREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Elyse Eberle, D.C.
• Brent J Eberle, RPH
• Michael Hermann Eberlein, MD
• Ann M Ebert, PHARMD
• Barbara Ebert, RN
• Steven C Ebert, PHARMD
• Brianna M Eby, PT
• Madaline Shipley Eck
• Susan Eck
• Todd M Eckelberg, M.D.

• Pediatric Urology Physician in Madison, WI
• Providers in Madison, WI by specialty
• Pediatric Urology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.