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1184621211

NPI Code Detail

MEDICARE: SSM HEALTH CARE OF WISCONSIN, INC.

MEDICARE: SSM HEALTH CARE OF WISCONSIN, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	275N00000X	Medicare Defined Swing Bed Hospital Unit
3	282N00000X	General Acute Care Hospital	71	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	390806393	OTHER	WI	INS PROVIDER NUMBER
2	5389107	OTHER	WI	PHYSICIANS PLUS PROVIDER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5283846	OTHER	WI	MEDICA PROVIDER NUMBER
5	67	OTHER	WI	DEANCARE PROVIDER NUMBER
6	A5371501	OTHER	WI	JOHN DEERE PROVIDER NUMBE
7	39080639301	OTHER	WI	UNITY PROVIDER NUMBER
8	390806393026	OTHER	WI	BLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number	:	1184621211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SSM HEALTH CARE OF WISCONSIN, INC.

Provider Business Mailing Address
First Line	:	700 S. PARK ST.
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53715-1830
Country	:	US
Telephone Number	:	608-251-6100
Fax Number	:	608-258-5221

Provider Business Practice Location Address
First Line	:	700 S. PARK ST.
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53715-1830
Country	:	US
Telephone Number	:	608-251-6100
Fax Number	:	608-258-5221

Authorized Official
Title or Position	:	SYSTEM DIR OF GOV REIMBURSEMENT
Name	:	JOSEPH MINERATH
Credential	:
Telephone Number	:	608-258-6891

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	01/21/2025

Similar Medicare Providers

1134123003 — DR. MARILYN J BORST M.D.
Practice Location Address:

700 S PARK ST
MADISON, WI
53715-1830

Practice Phone: 608-251-6100
Practice Fax:

1952308272 — PAUL KENNETH GAVINS PA-C
Practice Location Address:

700 S PARK ST
MADISON, WI
53715-1830

Practice Phone: 608-260-2900
Practice Fax: 608-260-3447

1821097593 — DR. MICHAEL DAVID ZOLINSKI M.D.
Practice Location Address:

700 S PARK ST
MADISON, WI
53715-1830

Practice Phone: 608-251-6100
Practice Fax: 608-258-5222

1386636272 — DR. FREDERICK FREITAG D.O.
Practice Location Address:

700 S PARK ST
MADISON, WI
53715-1830

Practice Phone: 608-260-2900
Practice Fax: 608-260-3444

1427043058 — ANAND MOHAN M.D.
Practice Location Address:

700 S PARK ST
MADISON, WI
53715-1830

Practice Phone: 608-251-6100
Practice Fax:

1003803339 — JEREMI THOMAS OLSON PA-C
Practice Location Address:

700 S PARK ST , DEAN ST. MARY'S OUTPATIENT CENTER
MADISON, WI
53715-1830

Practice Phone: 608-260-2900
Practice Fax: 608-260-7975

Directions to “SSM HEALTH CARE OF WISCONSIN, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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