Individual provider Active NPI

Hannah Macadaeg, BCBA

  • Behavior Analyst
  • Madison, WI
National Provider Identifier
1285091983
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
212140 Issued in WI
Practice address
559 Zor Shrine PL
Madison, WI 53719-2068
Phone
(608) 833-0123
Fax
(608) 833-0126
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 212140 WI Primary

Addresses

Primary practice location

559 Zor Shrine PL
Madison, WI 53719-2068

Mailing address

559 Zor Shrine PL
Madison, WI 53719-2068
Phone (608) 833-0123

Other practice location 1

1901 Carnegie Ave
1-C
Santa Ana, CA 92705-5504
Phone (714) 848-8319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
212140WIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Developmental Services, Inc Past Accepting new patients
Footprints Behavioral Interventions, Inc. PastSince Aug 2, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1285091983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 ZOR SHRINE PL",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192068",
            "telephone_number": "608-833-0123",
            "fax_number": "608-833-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 ZOR SHRINE PL",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192068",
            "telephone_number": "608-833-0123",
            "fax_number": "608-833-0126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Carnegie Ave",
            "address_2": "1-C",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927055504",
            "country_code": "US",
            "telephone_number": "714-848-8319",
            "fax_number": "714-596-6274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACADAEG",
        "first_name": "HANNAH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "212140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.