Organization Active NPI

Panda Care Wisconsin Sub LLC

  • In Home Supportive Care Agency
  • Madison, WI
National Provider Identifier
1417815317
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PANDA CARE WISCONSIN SUB LLC
Practice address
811 E Washington Ave Ste 400
Madison, WI 53703-4028
Phone
(313) 488-2349
NPI assigned
Jan 12, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Authorized official

Name
Vicki Drazin
Title
Owner
Phone
(313) 284-2501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

811 E Washington Ave Ste 400
Madison, WI 53703-4028

Mailing address

2733 E 12TH St
Brooklyn, NY 11235-4669

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1417815317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 E 12TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E WASHINGTON AVE STE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034028",
            "telephone_number": "313-488-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANDA CARE WISCONSIN SUB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "DRAZIN",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-284-2501"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "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 Sep 4, 2026; 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.