Individual provider Active NPI

Morgan Quackenboss, PA

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1750876694
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
675 W Washington Ave
Madison, WI 53703-2637
Phone
(608) 257-9700
NPI assigned
Jun 23, 2018
Last updated
Sep 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

675 W Washington Ave
Madison, WI 53703-2637

Mailing address

1002 N Westfield Rd
Madison, WI 53717-1021

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
I20180801000085 WI Practitioner - Physician Assistant 2769730233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

675 W Washington Ave
Madison, WI 53703-2637
Phone (608) 257-9700

8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766

Merit-based Incentive Payment System (MIPS)

Final score
82.21 of 100Reported as group
Quality
71.09
Promoting interoperability
99
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Savior Healthcare, Inc. CurrentSince Jul 16, 2018 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Jul 16, 2018 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1750876694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N WESTFIELD RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032637",
            "telephone_number": "608-257-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACKENBOSS",
        "first_name": "MORGAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-23",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.