Individual provider Active NPI

Michelle R Vanderbilt, N.P.

  • Nurse Practitioner
  • Madison, WI
National Provider Identifier
1881809275
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2372-033 Issued in WI
Practice address
1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone
(608) 252-8000
Fax
(608) 410-2905
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2372-033 WI Primary

Addresses

Primary practice location

1211 Fish Hatchery Rd
Madison, WI 53715-1909

Mailing address

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

Other practice location 1

2009 5th St
Monroe, WI 53566-1546
Phone (608) 324-2000

Other identifiers 1

IdentifierTypeStateIssuer
1881809275MedicaidWI

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address mvanderbilt263855@direct-ehr-ssmhc.com Direct
Direct Messaging Address mvanderbilt263855@direct-ehr-ssmhc.com Direct
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Other
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20141110001768 WI Practitioner - Nurse Practitioner 4789806621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2372-033WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Monroe Clinic, Inc. CurrentSince Mar 8, 2025 Accepting new patients
Agnesian Healthcare Inc CurrentSince Apr 15, 2025 Accepting new patients
Dean Health Systems, Inc CurrentSince Sep 25, 2017 Accepting new patients
Agnesian Healthcare, Inc CurrentSince Apr 15, 2025 Accepting new patients
The Monroe Clinic, Inc. CurrentSince Mar 8, 2025 Accepting new patients
Dean Health Systems, Inc. CurrentSince Sep 25, 2017 Accepting new patients

Locations

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

1200 John Q Hammons Dr
Ste 400
Madison, WI 53717
Phone (608) 410-2700

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

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

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

2009 5th St
Monroe, WI 53566
Phone (608) 324-1454

845 Parkside St
Ripon, WI 54971
Phone (920) 748-3101

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1881809275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-410-2905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-410-2905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2009 5th St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WI",
            "postal_code": "535661546",
            "country_code": "US",
            "telephone_number": "608-324-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERBILT",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2372-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881809275",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvanderbilt263855@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mvanderbilt263855@direct-ehr-ssmhc.com",
            "address_1": "1200 John Q Hammons Dr Ste 400",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537171967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvanderbilt263855@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mvanderbilt263855@direct-ehr-ssmhc.com",
            "address_1": "2009 5th St",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2009 5th St",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1200 John Q Hammons Dr Ste 400",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537171967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.