Individual provider Active NPI

Krista Vandenberg, NP

  • Nurse Practitioner
  • Madison, WI
National Provider Identifier
1679951636
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
164566 Issued in WI
Practice address
2880 University Ave
Madison, WI 53705-3644
Phone
(608) 263-7740
NPI assigned
May 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 6400 WI
Nurse Practitioner 363L00000X 164566 WI Primary

Addresses

Primary practice location

2880 University Ave
Madison, WI 53705-3644

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other names 1

  • Krista Anklam Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kvandenberg762362@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150701000067 WI Practitioner - Nurse Practitioner 2466764675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2880 University Ave
Madison, WI 53705-3644
Phone (608) 263-9339

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
164566WIMDNurse Practitioner
6400WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2015 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2015 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

5543 E Cheryl Pkwy
Fitchburg, WI 53711
Phone (608) 263-7740

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

2880 University Ave
Madison, WI 53705
Phone (608) 263-6421

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

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1679951636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 UNIVERSITY AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053644",
            "telephone_number": "608-263-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "KRISTA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "6400",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "164566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvandenberg762362@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "5543 E Cheryl Pkwy",
            "city": "Fitchburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537115376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "ANKLAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.