Individual provider Active NPI

Christian C Kastman, MD

  • Family Medicine Physician
  • Madison, WI
National Provider Identifier
1851331151
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50965 Issued in WI
Practice address
8202 Excelsior Dr
Madison, WI 53717-1906
Phone
(608) 831-1766
Fax
(608) 662-5622
NPI assigned
Jun 7, 2006
Last updated
Sep 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50965 WI Primary

Addresses

Primary practice location

8202 Excelsior Dr
Madison, WI 53717-1906

Mailing address

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

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
I20090806000495 WI Practitioner - Family Practice 3577616622 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50965WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Jul 20, 2009 Accepting new patients

Locations

1265 John Q Hammons Dr
Madison, WI 53717

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

Organizations & group practices 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1851331151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 EXCELSIOR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171906",
            "telephone_number": "608-831-1766",
            "fax_number": "608-662-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 EXCELSIOR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171906",
            "telephone_number": "608-831-1766",
            "fax_number": "608-662-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASTMAN",
        "first_name": "CHRISTIAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "50965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.