Wisconsin Kidney Care, S.c. is a medicare enrolled "Clinic/center" provider in Madison, Wisconsin. Their current practice location is
2810 Crossroads Dr Ste 4000, Office No. 4013, Madison, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(608) 747-7878.
Wisconsin Kidney Care, S.c. is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Wisconsin Kidney Care, S.c.
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1114539087.
Healthcare Provider's Profile
| Full Name | Wisconsin Kidney Care, S.c. |
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| Type | Facility |
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| Speciality | Clinic/center |
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| Location | 2810 Crossroads Dr Ste 4000, Madison, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1114539087
- Provider Enumeration Date: 08/20/2020
- Last Update Date: 07/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 6204255847
- Enrollment ID: O20200930002328
Medical Identifiers
Medical identifiers for Wisconsin Kidney Care, S.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114539087 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133VN1005X | Dietitian, Registered - Nutrition, Renal | (* (Not Available)) | Secondary |
| 163WC0400X | Registered Nurse - Case Management | (* (Not Available)) | Secondary |
| 163WN0300X | Registered Nurse - Nephrology | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Wisconsin Kidney Care, S.c. acts as a billing entity for following providers:
| Provider Name | Darci F Johnson |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1144990532
PECOS PAC ID: 7416346119
Enrollment ID: I20211118002099 |
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| Provider Name | Laura Gers |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1992085583
PECOS PAC ID: 6002066453
Enrollment ID: I20230713002380 |
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| Provider Name | Christine A Gallup |
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| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
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| Provider Identifiers | NPI Number: 1083981831
PECOS PAC ID: 8224422597
Enrollment ID: I20230928002070 |
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| Provider Name | Haley D Justus |
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| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
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| Provider Identifiers | NPI Number: 1861896672
PECOS PAC ID: 9638565633
Enrollment ID: I20240508000405 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wisconsin Kidney Care, S.c. is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Wisconsin Kidney Care, S.c.
1600 Stout St Ste 2000, Attn Strive Health Credentialing Team,
Denver, CO 80202-3113
Ph: (980) 443-4852 | Wisconsin Kidney Care, S.c.
2810 Crossroads Dr Ste 4000, Office No. 4013,
Madison, WI 53718
Ph: (608) 747-7878 |
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