Individual provider Active NPI

Katherine Ann Gonzaga, MD

  • Pediatric Allergy/Immunology Physician
  • Monona, WI
National Provider Identifier
1629118211
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
51711 Issued in WI
Practice address
6408 Copps Ave
Monona, WI 53716-3702
Phone
(608) 417-3000
NPI assigned
Feb 6, 2007
Last updated
Jan 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X 51711 WI Primary

Addresses

Primary practice location

6408 Copps Ave
Monona, WI 53716-3702

Mailing address

202 S Park St
Madison, WI 53715-1507

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgonzaga923219@direct.uwhealth.org

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
I20121003000806 WI Practitioner - Allergy/Immunology 2961651179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Loyola University of Chicago, Stritch School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20 S Park St
Madison, WI 53715-1348
Phone (608) 287-2076

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51711WIMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Apr 1, 2018 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Apr 1, 2018 Accepting new patients

Locations

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

20 S Park St
Madison, WI 53715
Phone (608) 287-2090

202 S Park St
Madison, WI 53715
Phone (608) 267-6000

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

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

6408 Copps Ave
Monona, WI 53716
Phone (608) 417-3000

251 2nd St
Reedsburg, WI 53959
Phone (608) 524-4334

Interoperability endpoints

  • Direct secure messaging: kgonzaga263400@direct.unitypoint.org
  • Direct secure messaging: kgonzaga923219@direct.uwhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1629118211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6408 COPPS AVE",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163702",
            "telephone_number": "608-417-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZAGA",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "WI",
            "license": "51711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgonzaga923219@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "20 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.