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Organization Active NPI

Saint Elizabeths Hospital of Wabasha Inc

Doing business as Gundersen St. Elizabeth's Hospital and Clinics

  • Home Health Agency
  • Wabasha, MN
National Provider Identifier
1053346825
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
330554 Issued in MN
Legal business name
SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Doing business as
Gundersen St. Elizabeth's Hospital and Clinics
Practice address
1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone
(651) 565-4531
Fax
(651) 565-2482
NPI assigned
Jul 11, 2006
Last updated
Mar 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT ELIZABETHS HOSPITAL OF WABASHA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Authorized official

Name
Mr. John K Wolfe
Title
Cfo
Phone
(651) 565-5553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 330554 MN Primary

Addresses

Primary practice location

1200 Grant Blvd W
Wabasha, MN 55981-1042

Mailing address

1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone (651) 565-4531

Other identifiers 4

IdentifierTypeStateIssuer
01015459OtherPREFERRED ONE HOME HEALTH
125054OtherMNUCARE FOR HOME HEALTH
1895AELOtherMNBCBS HOME HEALTH
41535100MedicaidWI

Other names 1

  • Gundersen St. Elizabeth's Hospital and Clinics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031119000811 MN Part B Supplier - Clinic/Group Practice 5092619387 Receives reassigned benefits from 157 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wabasha, MN
O20060314000172 MN Part A Provider - Home Health Agency 5092619387 Practice locations: Wabasha, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053346825. Details of each certification follow.

Home health agency certification: CCN 248028

Legal name
SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Doing business as
GUNDERSEN ST ELIZABETH'S HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 7, 1995
Last certification
Mar 14, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1965 in MN
Enrollment address
1200 Grant Blvd W
Wabasha, MN 55981-1042

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Gundersen St. Elizabeth's Home CareCCN 248028 · All quality measures
Overall star rating
1.5 of 5
Ownership
Non-Profit
Certified
Jul 7, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory
Part of
St Elizabeth Medical CT

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Paul McLellan Individual Corporate DirectorBoard Member Jan 1, 2026
James Root Individual Corporate DirectorAdministrator Sep 1, 2020
W-2 Managing Employee Jan 1, 2007
Richard Vaplon Individual Corporate DirectorBoard Member Jan 1, 2026
Bellin Gundersen Health System Inc Organization, La Crosse, WI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Nov 30, 2022 100%
Operational/Managerial Control Nov 30, 2022 100%
Paul R Fisch Individual Corporate DirectorBoard Member Sep 1, 2020
Emily Durand Individual Corporate Director Jan 1, 2023
Reece Rykal Individual Corporate DirectorBoard Member Jan 1, 2025
Michael J Ebersold Individual Corporate DirectorBoard Member Jul 1, 2016
Beverly Youngbauer Individual Corporate Director Jan 1, 2023
John K Wolfe Individual Corporate OfficerCfo Jan 1, 1992
W-2 Managing Employee Jan 1, 1992
Gundersen Lutheran Health System Inc Organization, La Crosse, WI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2020 100%
Operational/Managerial Control Aug 1, 2020 100%
Cindy Denk Individual Corporate DirectorBoard Secretary/Treasurer Oct 1, 2012
Daniel Coenen Individual Corporate DirectorBoard Member Jan 1, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 49

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 49

Practitioners & affiliated clinicians

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 58

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1053346825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531",
            "fax_number": "651-565-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531",
            "fax_number": "651-565-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ELIZABETHS HOSPITAL OF WABASHA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT ELIZABETHS HOSPITAL OF WABASHA INC",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-565-5553",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "330554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE HOME HEALTH",
            "identifier": "01015459",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE FOR HOME HEALTH",
            "identifier": "125054",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HOME HEALTH",
            "identifier": "1895AEL",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41535100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gundersen St. Elizabeth's Hospital and Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wabasha, MN

Sources for this page

Verify at the official NPI Registry.