Individual provider Active NPI

Connie Wang

  • Dermatology Physician
  • Madison, WI
National Provider Identifier
1639638521
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
77983-20 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-1147
Phone
(608) 263-6400
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 8224851 WI
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 77983-20 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-1147

Mailing address

600 Highland Ave
Madison, WI 53792-1147

Other practice location 1

1000 10th Ave
New York, NY 10019-1147
Phone (212) 259-6777

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
I20230825001730 WI Practitioner - Dermatology 4082944608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Columbia University College of Physicians and Surgeons, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, 2,537 clinicians

Practice addresses (Care Compare)

5249 E Terrace Dr
Madison, WI 53718-8339
Phone (608) 265-1295

Hospital & facility affiliations

  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098
  • Unitypoint Health - Meriter Hospital, Madison, WI, CCN 520089

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision65
Removal of skin lesions324
Removal or shaving of skin growth1-10
Skin biopsy224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8224851WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 1, 2023 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 1, 2023 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

5249 E Terrace Dr
Madison, WI 53718
Phone (608) 222-9777

1 S Park St
Madison, WI 53715
Phone (608) 287-2000

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

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

Interoperability endpoints

  • Direct secure messaging: cwang747710@direct.unitypoint.org

Organizations & group practices 4

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 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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1639638521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537921147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537921147",
            "telephone_number": "608-263-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-259-6777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "CONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "8224851",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "77983-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.