Active NPI
Cassidy Thiede
- Family Medicine Physician
- Madison, WI
National Provider Identifier
1619886009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1819233
- Practice address
- 4602 Eastpark Blvd
Madison, WI 53718-2002 - Phone
- (608) 617-8730
- NPI assigned
- Sep 2, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1819233 | WI | Primary |
Addresses
Primary practice location
4602 Eastpark Blvd
Madison, WI 53718-2002
Mailing address
N2983 County Road F
Montello, WI 53949-9013
Phone (608) 617-8730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1619886009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N2983 COUNTY ROAD F",
"city": "MONTELLO",
"state": "WI",
"postal_code": "539499013",
"telephone_number": "608-617-8730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4602 EASTPARK BLVD",
"city": "MADISON",
"state": "WI",
"postal_code": "537182002",
"telephone_number": "608-617-8730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIEDE",
"first_name": "CASSIDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-02",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "1819233",
"primary": true
}
],
"identifiers": [],
"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 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.