Individual provider Active NPI

Deborah K Boushea, MD

  • Internal Medicine Physician
  • Monona, WI
National Provider Identifier
1306813084
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26755 Issued in WI
Practice address
5012 Midmoor Rd
Monona, WI 53716-2619
Phone
(608) 230-6682
NPI assigned
Mar 2, 2006
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26755 WI Primary

Addresses

Primary practice location

5012 Midmoor Rd
Monona, WI 53716-2619

Mailing address

5012 Midmoor Rd
Monona, WI 53716-2619

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dboushea207@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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000632 WI Practitioner - Internal Medicine 7719020650 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26755WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 1, 2002 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 1, 2002 Accepting new patients

Locations

20 S Park St
Madison, WI 53715
Phone (608) 287-2090

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

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

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1306813084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 MIDMOOR RD",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537162619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 MIDMOOR RD",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537162619",
            "telephone_number": "608-230-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSHEA",
        "first_name": "DEBORAH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "26755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dboushea207@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "20 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.