Individual provider Active NPI

Nathaniel L Stephens

  • Certified Registered Nurse Anesthetist
  • Madison, WI
National Provider Identifier
1609518570
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
12031-33 Issued in WI
Practice address
700 S Park St
Madison, WI 53715-1830
Phone
(608) 251-6100
Fax
(608) 258-6975
NPI assigned
Apr 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 12031-33 WI Primary

Addresses

Primary practice location

700 S Park St
Madison, WI 53715-1830

Mailing address

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Other identifiers 1

IdentifierTypeStateIssuer
1609518570MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220728002533 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082096672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Hospital & facility affiliations

  • SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
  • SSM Health St Mary'S Hospital - Janesville Hospital, Janesville, WI, CCN 520208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Jul 29, 2022 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jul 29, 2022 Accepting new patients

Locations

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

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

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

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 and National Provider Directory roles.

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": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1609518570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-251-6100",
            "fax_number": "608-258-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-251-6100",
            "fax_number": "608-258-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "NATHANIEL",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "12031-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609518570",
            "state": "WI"
        }
    ],
    "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 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.