NPIMap

Organization Active NPI

University of Wisconsin Medical Foundation Inc

  • Durable Medical Equipment & Medical Supplies
  • Madison, WI
National Provider Identifier
1902866783
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC
Practice address
3209 Dryden Dr
Madison, WI 53704-3015
Phone
(608) 241-9020
Fax
(608) 833-6932
NPI assigned
Mar 24, 2006
Last updated
Jul 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Authorized official

Name
Robert Flannery
Title
Cao & Cfo
Phone
(608) 821-4223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

3209 Dryden Dr
Madison, WI 53704-3015

Mailing address

7974 Uw Health Court
Middleton, WI 53562-5531
Phone (608) 829-5270

Other identifiers 1

IdentifierTypeStateIssuer
41729100MedicaidWI

Other names 1

  • UW Health Northeast Family Medicine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930059719 WI DME Supplier - Physician - Family Practice 6608785464 Practice locations: Madison, WI

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0393625Uw Health Northport Family Medical Center3209 Dryden Dr, Madison, WI 53704Certificate of waiverJan 1, 2028

National Provider Directory

National Provider Directory
Tax ID family
Uwmf Inc Fam Prac26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Uw Health Care DirectMiddleton, WI, CCN 527220 Home health agency 5% Or Greater Indirect Ownership Interest (50%) Jul 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467849600000",
    "number": "1902866783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH COURT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531",
            "telephone_number": "608-829-5270",
            "fax_number": "608-833-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 DRYDEN DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043015",
            "telephone_number": "608-241-9020",
            "fax_number": "608-833-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2016-07-07",
        "status": "A",
        "authorized_official_last_name": "FLANNERY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CAO & CFO",
        "authorized_official_telephone_number": "608-821-4223"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41729100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UW Health Northeast Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.