1. Home
  2. Directory
  3. Wisconsin
  4. Madison
  5. Clinic Center
  6. NPI Profile

COMMUNITY MEDICAL SERVICES MADISON ON BROADWAY
NPI 1720701949
Clinic/Center - Methadone in Madison, WI

Active since September 22, 2022
4802 E BROADWAY, MADISON, WI 53716(608) 889-7500(480) 687-7361 Get Directions Write a Review

NPPES record last updated: February 10, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 10, 2024, Sep 22, 2022 (2 updates tracked since 2022).

About Community Medical Services Madison On Broadway NPPES

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

COMMUNITY MEDICAL SERVICES MADISON ON BROADWAY (NPI 1720701949) is a healthcare organization registered as a methadone in Madison, Wisconsin and active in the NPI registry since September 2022. The organization lists Cindy Gaither, Vice President Revenue Cycle Mgmt, as its authorized official.

NPPES Registry Identity

NPI1720701949
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NamePREMIER CARE OF WISCONSIN, LLC.
Location Address4802 E BROADWAYMadison, WI 53716-4141
Mailing Address8444 N 90th St Ste 100Scottsdale, AZ 85258-4437 · (602) 248-8886 · Fax (480) 687-7361
Phone(608) 889-7500
Fax(480) 687-7361
Organization SubpartNo
Authorized OfficialCindy GaitherVice President Revenue Cycle Mgmt · (602) 248-8886
Enumeration DateSeptember 22, 2022
Last NPPES UpdateFebruary 10, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2024
✔ NPI 1720701949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
4802 E BROADWAY, Madison, WI 53716
Open in Google Maps ↗

Other Names 1

Doing Business AsCommunity Medical Services Madison On Broadway

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Quartz.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 52D2266138

Community Medical Services-Madison On Broadway · Madison, WI
Expired · Aug 4, 2026
CLIA Number52D2266138
Laboratory TypeOutpatient Treatment
Certificate Effective DateAugust 5, 2024
Certificate Expiration DateAugust 4, 2026
Laboratory DirectorJustin M. Abeyta
Laboratory Phone(608) 889-7500
Laboratory LocationCommunity Medical Services-Madison On Broadway4802 E Broadway, Madison, WI 53716
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

KA PA YANG APNP
Nurse Practitioner (Family)
4802 E BROADWAY
MADISON, WI 53716
Dane County (608) 889-7500
AMY A LANZENDORF SAC-IT
Counselor (Addiction (Substance Use Disorder))
4802 E BROADWAY
MADISON, WI 53716
Dane County (608) 926-0101
CRYSTAL KOLSTAD RN
Registered Nurse (Addiction (Substance Use Disorder))
4802 E BROADWAY
MADISON, WI 53716
Dane County (608) 889-7500
DAVID J DIETRICH
Registered Nurse
4802 E BROADWAY
MADISON, WI 53716
Dane County (608) 889-7500
ISABELL SCHUEFFNER
Counselor (Addiction (Substance Use Disorder))
4802 E BROADWAY
MADISON, WI 53716
Dane County (608) 889-7500
KAYLA HOTZ FNP-C
Nurse Practitioner (Primary Care)
4802 E BROADWAY
MADISON, WI 53716
Dane County (608) 889-7500
EMILY R SIMEON RN
Registered Nurse
4802 E BROADWAY
MADISON, WI 53716
Dane County (608) 889-7500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premier Care Of Wisconsin, LLC.'s NPI number?

The NPI number for Premier Care Of Wisconsin, LLC. is 1720701949. It was assigned to this organization in the NPPES registry on September 22, 2022. The provider is doing business as Community Medical Services Madison On Broadway.

Where is Premier Care Of Wisconsin, LLC. located?

Premier Care Of Wisconsin, LLC. is located at 4802 E Broadway, Madison, WI 53716. The listed phone number is (608) 889-7500.

What is Premier Care Of Wisconsin, LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

What insurance does Premier Care Of Wisconsin, LLC. accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and Quartz list Premier Care Of Wisconsin, LLC. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Premier Care Of Wisconsin, LLC. was last updated on February 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.