Individual provider Active NPI

Patricia Ruth Witte, MD

  • Family Medicine Physician
  • Madison, WI
National Provider Identifier
1861481699
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38146-20 Issued in WI
Practice address
675 W Washington Ave
Madison, WI 53703-2637
Phone
(608) 257-9700
Fax
(608) 258-9042
NPI assigned
Oct 14, 2005
Last updated
Jun 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20020452 NM
Family Medicine Physician 207Q00000X 38146-20 WI Primary

Addresses

Primary practice location

675 W Washington Ave
Madison, WI 53703-2637

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
48535729MedicaidNM
764581MedicaidAZ
57933529MedicaidCO

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
I20110620000508 WI Practitioner - Family Practice 1759477037 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20020452NMMDFamily Medicine Physician
38146-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Jun 15, 2011 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Past Accepting new patients

Locations

675 W Washington Ave
Madison, WI 53703
Phone (608) 257-5178

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

Organizations & group practices 2

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1861481699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032637",
            "telephone_number": "608-257-9700",
            "fax_number": "608-258-9042"
        },
        {
            "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",
            "fax_number": "608-258-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTE",
        "first_name": "PATRICIA",
        "middle_name": "RUTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "20020452",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "38146-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48535729",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764581",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57933529",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.