Individual provider Active NPI

Traci L Gundlach, NP

  • Nurse Practitioner
  • Madison, WI
National Provider Identifier
1982106555
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8315 Issued in WI
Practice address
1 S Park St
Madison, WI 53715-1375
Phone
(608) 287-2434
Fax
(608) 287-2182
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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 8315 WI Primary

Addresses

Primary practice location

1 S Park St
Madison, WI 53715-1375

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgundlach923972@direct.uwhealth.org

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
I20180427001600 WI Practitioner - Nurse Practitioner 6406110428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
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)

1 S Park St
Madison, WI 53715-1375
Phone (608) 287-2000

Hospital & facility affiliations

  • Unitypoint Health - Meriter Hospital, Madison, WI, CCN 520089
  • 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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8315WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince May 7, 2018 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince May 7, 2018 Accepting new patients

Locations

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

1 S Park St
Madison, WI 53715
Phone (608) 287-2000

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

Interoperability endpoints

  • Direct secure messaging: tgundlach623877@direct.unitypoint.org

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 3

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1982106555",
    "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": "1 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151375",
            "telephone_number": "608-287-2434",
            "fax_number": "608-287-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDLACH",
        "first_name": "TRACI",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgundlach923972@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.