Individual provider Active NPI

Tracy L Haack, PA-C

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1477741577
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2204-23 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-1909
Phone
(608) 263-0333
NPI assigned
Oct 15, 2007
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2204-23 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-1909

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

2501 W Beltline Hwy
Suite 601
Madison, WI 53713-2318
Phone (608) 294-6464

Other practice location 2

2501 W Beltline Hwy
Suite 601
Madison, WI 53713-2318
Phone (608) 288-6600

Other identifiers 1

IdentifierTypeStateIssuer
1477741577MedicaidWI

Other names 1

  • Tracy L. Nonn Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address thaack262281@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address thaack7214139@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071024000687 WI Practitioner - Physician Assistant 3870680713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

202 S Park St
Madison, WI 53715-1507
Phone (608) 287-2050

4602 Eastpark Blvd
Madison, WI 53718-2002
Phone (608) 440-6400

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2204-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Oct 17, 2007 Accepting new patients
Dean Health Systems, Inc. CurrentSince Oct 17, 2007 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Dec 2, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Dec 2, 2024 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

2501 W Beltline Hwy
Ste 601
Madison, WI 53713
Phone (608) 234-7436

4602 Eastpark Blvd
Madison, WI 53718
Phone (608) 263-7540

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

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

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

100 N Main St
Richland Ctr, WI 53581
Phone (608) 647-8995

Organizations & group practices 5

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 2

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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1477741577",
    "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": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537921909",
            "telephone_number": "608-263-0333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 W Beltline Hwy",
            "address_2": "Suite 601",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537132318",
            "country_code": "US",
            "telephone_number": "608-294-6464",
            "fax_number": "608-288-6495",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 W Beltline Hwy",
            "address_2": "Suite 601",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537132318",
            "country_code": "US",
            "telephone_number": "608-288-6600",
            "fax_number": "608-288-6495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAACK",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2204-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477741577",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thaack262281@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "thaack262281@direct-ehr-ssmhc.com",
            "address_1": "1211 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151909",
            "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": "1211 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thaack7214139@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "600 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537921909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "NONN",
            "middle_name": "L.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.