Individual provider Active NPI

David Eckerle, MD

  • Internal Medicine Physician
  • Madison, WI
National Provider Identifier
1487673273
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33624 Issued in WI
Practice address
675 W Washington Ave
Madison, WI 53703-2637
Phone
(608) 257-9700
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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 33624 WI Primary

Addresses

Primary practice location

675 W Washington Ave
Madison, WI 53703-2637

Mailing address

1265 John Q Hammons Dr
Madison, WI 53717-1941
Phone (608) 251-4156

Other identifiers 1

IdentifierTypeStateIssuer
31868800MedicaidWI

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
I20050512000189 WI Practitioner - Internal Medicine 7012957780 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33624WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Jul 1, 1994 Accepting new patients

Locations

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

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

1265 John Q Hammons Dr
Madison, WI 53717

675 W Washington Ave
Madison, WI 53703
Phone (608) 257-5178

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1487673273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 JOHN Q HAMMONS DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171941",
            "telephone_number": "608-251-4156",
            "fax_number": "608-257-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032637",
            "telephone_number": "608-257-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERLE",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "33624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31868800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.