Individual provider Active NPI

Martha Leigh Rolli, MD

  • Psychiatry Physician
  • Monona, WI
National Provider Identifier
1568438711
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34559 Issued in WI
Practice address
6007 Winnequah Road
Monona, WI 53716
Phone
(608) 265-8130
Fax
(608) 263-7263
NPI assigned
Feb 27, 2006
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34559 WI Primary

Addresses

Primary practice location

6007 Winnequah Road
Monona, WI 53716

Mailing address

6007 Winnequah Road
Monona, WI 53716
Phone (608) 235-5368

Other identifiers 1

IdentifierTypeStateIssuer
31971300MedicaidWI

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
I20110120001234 WI Practitioner - Psychiatry 4981883071 Reassigns benefits to 1 organization
Practice locations: Stoughton, WI

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34559WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winnebago Mental Health Institute CurrentSince Aug 31, 2010 Accepting new patients
State of Wisconsin CurrentSince Aug 31, 2010 Accepting new patients

Locations

317 Knutson Dr
Madison, WI 53704
Phone (608) 301-9200

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1568438711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 WINNEQUAH ROAD",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "53716",
            "telephone_number": "608-235-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6007 WINNEQUAH ROAD",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "53716",
            "telephone_number": "608-265-8130",
            "fax_number": "608-263-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLI",
        "first_name": "MARTHA",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "34559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31971300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.