Individual provider Active NPI

Kathleen R Maginot, MD

  • Pediatric Cardiology Physician
  • Madison, WI
National Provider Identifier
1922074095
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
45589 Issued in WI
Practice address
7702 Welton Dr
Madison, WI 53719-3026
Phone
(608) 843-9302
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Congenital Heart Disease Physician 207RA0002X 45589 WI
Pediatric Cardiology Physician 2080P0202X 45589 WI Primary

Addresses

Primary practice location

7702 Welton Dr
Madison, WI 53719-3026

Mailing address

7702 Welton Dr
Madison, WI 53719-3026
Phone (608) 843-9302

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
I20050114000516 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric MedicinePractitioner - Adult Congenital Heart Disease (Achd) 9739138983 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45589WIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Jan 1, 2016 Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Mar 27, 2021 Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince Jan 1, 2016 Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Mar 27, 2021 Accepting new patients

Locations

1050 Division St
Mauston, WI 53948
Phone (608) 847-6161

1040 Division St
Mauston, WI 53948
Phone (608) 847-5000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

28 Commerce St
Wisconsin Dells, WI 53965
Phone (608) 254-5888

Interoperability endpoints

  • Direct secure messaging: kmaginot665988@direct.emplifyhealth.org

Organizations & group practices 4

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1922074095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 WELTON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537193026",
            "telephone_number": "608-843-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 WELTON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537193026",
            "telephone_number": "608-843-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGINOT",
        "first_name": "KATHLEEN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "WI",
            "license": "45589",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WI",
            "license": "45589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.