MARK KLEEDEHN (NPI# 1508187964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508187964 |
| Entity Type | Individual |
| Full Name | MARK KLEEDEHN |
| Credential | M.D. |
| Practice Address |
202 S Park St Madison WI 53715-1507 |
| Mailing Address |
7974 Uw Health Ct Middleton WI 53562-5531 |
| Practice Telephone | 6084176090 |
| Practice Fax Number | 6084176281 |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2018-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
58838 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
202 S PARK ST |
| City | MADISON |
| State | WI |
| Zip Code | 53715-1507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920048 | Meriter Hospital, Inc. | General Practice | 202 S Park St, Madison, WI 53715-1507 | 2005-05-24 |
| 1295333839 | Monica Steigerwald | Physical Therapist | 202 S Park St, Madison, WI 53715-1507 | 2020-10-15 |
| 1376158667 | Sari L Archer | Nurse Practitioner | 202 S Park St, Madison, WI 53715-1507 | 2020-09-13 |
| 1376152710 | Jeffrey Jaeggi | Physical Therapist | 202 S Park St, Madison, WI 53715-1507 | 2020-07-30 |
| 1114544673 | Karina Kidd | Genetic Counselor, MS | 202 S Park St, Madison, WI 53715-1596 | 2020-07-01 |
| 1801412606 | Trevor Francis Boensch | Anesthesiologist Assistant | 202 S Park St, Madison, WI 53715-1507 | 2020-06-18 |
| 1225657539 | Joseph W Liggett Jr. | Clinical Nurse Specialist | 202 S Park St, Madison, WI 53715-1507 | 2020-04-16 |
| 1467081711 | Gabrielle Maria Avery | Student in an Organized Health Care Education/Training Program | 202 S Park St, Madison, WI 53715-1507 | 2020-04-07 |
| 1033748439 | Landon Jennings-stoyles | Pharmacist | 202 S Park St, Madison, WI 53715-1507 | 2020-04-07 |
| 1073140950 | Aaron Gilmour | Occupational Therapist | 202 S Park St, Madison, WI 53715-1507 | 2020-03-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1578927026 | Petra A Kelsey | Family Medicine | 1107 Emerald St, Madison, WI 53715 | 2016-04-11 |
| 1467889238 | Group Health Cooperative of South Central Wi | Durable Medical Equipment & Medical Supplies | 740 Regent Street, Suite 106, Madison, WI 53715 | 2013-10-10 |
| 1275888760 | Sandra Beth Miller | Physician Assistant | 700 S. Park, Suite A 404, Madison, WI 53715 | 2012-07-20 |
| 1134418486 | Matthew Lochen | Emergency Medicine | 700 S. Park Street, Department of Emergency Medicine, Madison, WI 53715 | 2011-04-06 |
| 1225275720 | Eileen J Breitweiser | Social Worker | 202 South Parkt Street, Madison, WI 53715 | 2009-01-21 |
| 1225293137 | Kenneth H. Yuska, Md, Sc | Orthopaedic Surgery | 4726 East Towne Blvd., 110, Madison, WI 53715 | 2008-07-21 |
| 1063689727 | Rachel I Kornik | Dermatology | Uw Health Dept of Dermatology 1 S. Park St, Administrative Office 7th Floor, Madison, WI 53715 | 2008-05-13 |
| 1144434911 | Rebecca Sue Frye | Pharmacist | 1 South Park Street, Suite 101 Pharmacy, Madison, WI 53715 | 2007-05-10 |
| 1376755496 | Eileen C. Scrivner | Social Worker | 1008 Fish Hatchery Road, Madison, WI 53715 | 2007-05-03 |
| Find all providers in zip 53715 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720443922 | Elliott Russell | Radiology | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792-0001 | 2015-12-15 |
| 1447666219 | Chadi Diab | Radiology | 600 Highland Ave, Madison, WI 53792-2709 | 2014-07-01 |
| 1356785281 | Aaron Lee Reposar | Radiology | 600 Highland Ave, Madison, WI 53792-0001 | 2013-04-22 |
| 1548525348 | Aaron Cole Eifler | Radiology | 600 Highland Ave, Madison, WI 53792 | 2012-07-08 |
| 1902030778 | Paul Laeseke | Radiology | 600 Highland Ave, Madison, WI 53792-0001 | 2009-05-08 |
| 1639339971 | Jason William Pinchot | Radiology | 600 Highland Ave, Madison, WI 53792-0001 | 2008-06-10 |
| 1477757797 | Prasad Surendranath Dalvie | Radiology | 600 Highland Ave, Csc - D4/336, Madison, WI 53792 | 2007-06-12 |
| 1821208174 | John Michael Fallucca | Radiology | 600 Highland Ave, Madison, WI 53792-0001 | 2007-05-23 |
| 1720297112 | Conrad David Pun | Radiology | 202 S Park St, Meriter Hospital - Medical Imaging, Madison, WI 53715-1507 | 2007-05-22 |
| 1043394398 | Orhan Seref Ozkan | Radiology | 600 Highland Ave, Madison, WI 53792-3284 | 2006-10-24 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.