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UW HEALTH 1102 S PARK
NPI 1174965008
Durable Medical Equipment & Medical Supplies in Madison, WI

Active since July 19, 2013CLIA 52D2238047 · Waiver
1102 S PARK ST, 2ND FLOOR, MADISON, WI 53715(608) 287-5899 Get Directions Write a Review

NPPES record last updated: July 7, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Uw Health 1102 S Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UW HEALTH 1102 S PARK (NPI 1174965008) is a healthcare organization registered as a durable medical equipment & medical supplies in Madison, Wisconsin and active in the NPI registry since July 2013. The organization holds a CLIA Waiver certificate valid through June 30, 2027 and lists Robert Flannery, Cao & Cfo, as its authorized official.

NPPES Registry Identity

NPI1174965008
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameUNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC
Location Address1102 S PARK ST, 2ND FLOORMadison, WI 53715-1708
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531 · (608) 829-5485 · Fax (608) 833-5039
Phone(608) 287-5899
Organization SubpartNo
Authorized OfficialRobert FlanneryCao & Cfo · (608) 821-4223
Enumeration DateJuly 19, 2013
Last NPPES UpdateJuly 7, 2016
✔ NPI 1174965008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

1102 S PARK ST, Madison, WI 53715
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Other Names 1

Doing Business AsUw Health 1102 S Park

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2238047

Uw Health 1102 S Park St Clinic · Madison, WI
Active · expires Jun 30, 2027
CLIA Number52D2238047
Laboratory TypePhysician Office
Certificate Effective DateJuly 1, 2025
Certificate Expiration DateJune 30, 2027
Laboratory DirectorDr. David T. Yang
Laboratory Phone(608) 263-7506
Laboratory LocationUw Health 1102 S Park St Clinic1102 S Park St, Madison, WI 53715
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 52D0867224

Uw Health 1 S Park Poc · Madison, WI
Active · expires Apr 30, 2027
CLIA Number52D0867224
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2025
Certificate Expiration DateApril 30, 2027
Laboratory DirectorDr. Derrick Chen
Laboratory Phone(608) 916-0290
Laboratory LocationUw Health 1 S Park Poc1 S Park St, Madison, WI 53715
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JEFFREY CZEBOTAR LPC, SAC
Counselor (Professional)
1102 S PARK ST
MADISON, WI 53715
Dane County (608) 282-8270
CHRISTINA A LIGHTBOURN MS
Counselor (Addiction (Substance Use Disorder))
1102 S PARK ST
MADISON, WI 53715
Dane County (608) 282-8270
JULITA ANNA JANKOWSKA LICENSED PROFESSIONA
Counselor (Professional)
1102 S PARK ST
MADISON, WI 53715
Dane County (608) 282-8270
MRS. STACY A LEIDEL APNP
Nurse Practitioner
1102 S PARK ST
MADISON, WI 53715
Dane County (608) 263-3111
SANDRA HENDRICKS MSSW
Social Worker (Clinical)
1102 S PARK ST, SUITE 400
MADISON, WI 53715
Dane County (608) 282-8270
ACCESS COMMUNITY HEALTH CENTERS, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
1102 S PARK ST
MADISON, WI 53715
Dane County (608) 443-5500
RACHAEL MARIE FINN PA-C
Physician Assistant (Medical)
1102 S PARK ST
MADISON, WI 53715
Dane County (608) 287-5899
MR. JOEL R HILL PA-C
Physician Assistant
1102 S PARK ST
MADISON, WI 53715
Dane County (608) 263-3111

Frequently Asked Questions

What is UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC's NPI number?

The NPI number assigned to this healthcare provider is 1174965008, enumerated as an "organization" on July 19, 2013.

Where is the provider located?

The provider is located at 1102 S PARK ST 2ND FLOOR MADISON, WI 53715 and the phone number is (608) 287-5899.

What is the provider's specialty?

Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.