Careconnectmd Wisconsin Professional Corporation
Organization Active NPI General Practice Physician · Waunakee, WI
NPI 1619658176 · NPPES record last updated Nov 20, 2025
Key facts
- NPI
- 1619658176
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- CARECONNECTMD WISCONSIN PROFESSIONAL CORPORATION
- Practice address
- 1025 Quinn Dr FL 1
Waunakee, WI 53597-2502 - Phone
- (888) 789-9585
- NPI assigned
- Jul 27, 2023
- Organization subpart
- No
Authorized official
- Name
- Hyong Kim, MD
- Title
- Owner
- Phone
- (888) 789-9585
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251217002531 | WI | Part B Supplier - Clinic/Group Practice | 9830684836 |
Receives reassigned benefits from 1 practitioner Practice locations: Waunakee, WI |
National Provider Directory
Locations
1025 Quinn Dr
Fl 1
Waunakee, WI 53597
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
1025 Quinn Dr FL 1
Waunakee, WI 53597-2502
Mailing address
3090 Bristol St Ste 200
Costa Mesa, CA 92626-3061
Other providers in Waunakee, WI
- Melissa Mary Carole Bowe
- Lynn M Braun
- Taylor Leigh Brown
- Curtis W Bush
- Lilian Busse
- Elizabeth Ann Carr
- Centered Physical Therapy & Wellness
- Leah Chase
- Chirophysics LLC
- Ashley Clemens
All providers in Waunakee, WI · General Practice Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.