Individual provider Active NPI

Samuel G Dillman, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Madison, WI
National Provider Identifier
1891149191
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
68118 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-4619
Phone
(608) 262-2398
NPI assigned
Apr 22, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 68118 WI
Pediatrics Physician 208000000X 2019024479 MO
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 68118 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-4619

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (262) 949-6622

Other practice location 2

7624 W Lorraine Pl
Milwaukee, WI 53222-5038
Phone (262) 949-6622

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
I20220803003368 WI Practitioner - Emergency Medicine 9234493602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, 2,537 clinicians

Practice addresses (Care Compare)

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Hospital & facility affiliations

  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
68118WIMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2022 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2022 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

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

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 1

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": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1891149191",
    "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": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537924619",
            "telephone_number": "608-262-2398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Gillham Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641084619",
            "country_code": "US",
            "telephone_number": "262-949-6622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7624 W Lorraine Pl",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532225038",
            "country_code": "US",
            "telephone_number": "262-949-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLMAN",
        "first_name": "SAMUEL",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "68118",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2019024479",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "WI",
            "license": "68118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.