Jon Dirk Van Roo, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

53967-20 Issued in WI

Practice address

700 S Park St
Suite A404
Madison, WI 53715-1830

Phone

(608) 258-6504

NPI assigned

Apr 25, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

79.19 of 100Reported as group

Quality

74.01

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Madison Emergency Physicians, SC

  • Emergency Medicine Physician
  • Madison, WI
  • NPI 1588646095
  Medicare reassignment NPD
• Prairie Ridge Health, Inc.

  • Critical Access Hospital
  • Columbus, WI
  • NPI 1841376183
  Medicare reassignment NPD
• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1891796710
  Medicare reassignment NPD
• Upland Hills Health, Inc

  dba Upland Hills Hospice

  • Community Based Hospice Care Agency
  • Dodgeville, WI
  • NPI 1659472397
  Medicare reassignment
• Prairie Ridge Health Inc.

  dba Prairie Ridge Health Clinic-Sun Prairie

  • Family Medicine Physician
  • Sun Prairie, WI
  • NPI 1699534545
  NPD
• Prairie Ridge Health, Inc.

  • Orthopaedic Surgery Physician
  • Columbus, WI
  • NPI 1912329335
  NPD
• Reedsburg Area Medical Center Inc

  dba RAMC La Valle Clinic

  • Rural Health Clinic/Center
  • La Valle, WI
  • NPI 1437049566
  NPD
• Reedsburg Area Medical Center, Inc.

  • Family Medicine Physician
  • Reedsburg, WI
  • NPI 1457780983
  NPD
• Upland Hills Health, Inc

  dba UHH Emergency Physicians

  • Emergency Medicine Physician
  • Dodgeville, WI
  • NPI 1598163537
  NPD
• Upland Hills Health, Inc.

  dba Upland Hills Health

  • Critical Access Hospital
  • Dodgeville, WI
  • NPI 1487745501
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1033384565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "SUITE A404",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-258-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "SUITE A404",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-258-6504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-926-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN ROO",
        "first_name": "JON",
        "middle_name": "DIRK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-25",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125051916",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "53967-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIRAPI",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvanroo263844@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jvanroo263844@direct-ehr-ssmhc.com",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eva Van Leer, SLP
• Pamela Faye Van Mol, RN
• Sarah Haley Van Ness, PA
• Shelly Jean Van Note, PHARM D
• Sarah E. Van Riet, RD, CDE, LN
• Linda M Van Tol, LMFT, CSAC
• Michael J Van Veghel, ATC
• Elan Inez Van Vlack, MS
• Eric W Van Zon, D.C.
• Jordyn Van

• Emergency Medicine Physician in Madison, WI
• Providers in Madison, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.