Individual provider Active NPI

Ryan D Luellwitz, DO

  • Obstetrics & Gynecology Physician
  • Madison, WI
National Provider Identifier
1316388903
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
67589-21 Issued in WI
Practice address
20 S Park St
Madison, WI 53715-1348
Phone
(608) 287-2830
Fax
(608) 890-6797
NPI assigned
Jul 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 67589 WI
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 67589 WI
Obstetrics & Gynecology Physician 207V00000X 67589-21 WI Primary

Addresses

Primary practice location

20 S Park St
Madison, WI 53715-1348

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other identifiers 1

IdentifierTypeStateIssuer
1316388903MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rluellwitz260831@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20170815003726 WI Practitioner - Obstetrics/GynecologyPractitioner - Critical Care (Intensivists)Practitioner - Anesthesiology 7012289721 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Critical Care (Intensivists)
Education
Midwestern University, Chicago College of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67589WIMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Wisconsin, S.C. Obstetrics & Gynecology CurrentSince Jun 26, 2020 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Dean Health Systems, Inc. CurrentSince Jul 26, 2017 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 1, 2021 Accepting new patients
Dean Health Systems, Inc Anesthesiology CurrentSince Jul 26, 2017 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 1, 2021 Accepting new patients

Locations

700 S Park St
Ste A
Madison, WI 53715
Phone (608) 260-2900

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

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

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

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

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: rluellwitz836423@direct.unitypoint.org

Organizations & group practices 6

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.

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1316388903",
    "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": "20 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151348",
            "telephone_number": "608-287-2830",
            "fax_number": "608-890-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUELLWITZ",
        "first_name": "RYAN",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "67589",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "WI",
            "license": "67589",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "67589-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316388903",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rluellwitz260831@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rluellwitz260831@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.