Individual provider Active NPI

Nadine S. Fakhran, PA-C

  • Medical Physician Assistant
  • Madison, WI
National Provider Identifier
1295468874
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7407-23 Issued in WI
Practice address
1102 S Park St Ste 200
Madison, WI 53715-1708
Phone
(608) 263-7500
NPI assigned
Jul 1, 2022
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 7407-23 WI Primary

Addresses

Primary practice location

1102 S Park St Ste 200
Madison, WI 53715-1708

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

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
I20230814001490 WI Practitioner - Physician Assistant 7214399864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 S Park St
Madison, WI 53715-1375
Phone (608) 287-2000

1050 E Broadway
Monona, WI 53716-4023
Phone (608) 222-8779

1102 S Park
Floors 2 and 4
Madison, WI 53715-1714
Phone (608) 287-5899

1102 S Park St
Madison, WI 53715-1714
Phone (608) 287-2770

20 S Park St
Madison, WI 53715-1348
Phone (608) 287-2076

2402 Winnebago St
Madison, WI 53704-5341
Phone (608) 287-2770

2418 Brewery Rd
Cross Plains, WI 53528-9470
Phone (608) 798-3344

2977 County Hwy CX
Portage, WI 53901-9271
Phone (608) 287-2770

3209 Dryden Dr
Madison, WI 53704-3015
Phone (608) 287-2770

500 Midland CT
Janesville, WI 53546-2341
Phone (608) 916-2600

5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376
Phone (608) 274-5300

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

600 N 8TH St
Mount Horeb, WI 53572-1870
Phone (608) 287-2770

7102 Mineral Point Rd
Madison, WI 53717-1706
Phone (608) 828-7603

7974 Uw Health CT
Middleton, WI 53562-5531

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 Sep 11, 2023 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 11, 2023 Accepting new patients
University of Wisconsin Medical Foundation Inc PastSince Aug 13, 2023 Accepting new patients

Locations

1102 S Park St
Ste 200
Madison, WI 53715
Phone (608) 263-7500

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

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

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1295468874",
    "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": "1102 S PARK ST STE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151708",
            "telephone_number": "608-263-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHRAN",
        "first_name": "NADINE",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "7407-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.