NPIMap

Organization Active NPI

Mercy Health System Corporation

Doing business as Mercy Hospital Janesville

  • General Acute Care Hospital
  • Janesville, WI
National Provider Identifier
1093768962
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
310800 Issued in WI
Legal business name
MERCY HEALTH SYSTEM CORPORATION
Doing business as
Mercy Hospital Janesville
Practice address
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone
(608) 756-6000
NPI assigned
May 19, 2006
Last updated
Jun 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Joseph D Malas
Title
Cfo
Phone
(815) 971-6738

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 310800 WI
Adolescent and Children Mental Health Clinic/Center 261QM0855X 310800 WI
Physical Therapy Clinic/Center 261QP2000X 310-800 WI
General Acute Care Hospital 282N00000X 310800 WI Primary
Clinical Medical Laboratory 291U00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X 310800 WI
Occupational Therapist 225X00000X 310-800 WI

Addresses

Primary practice location

1000 Mineral Point Ave
Janesville, WI 53548-2940

Mailing address

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

Other practice location 1

903 Mineral Point Ave
Janesville, WI 53548-2970
Phone (608) 756-5555

Other practice location 2

3400 Deerfield Drive
Janesville, WI 53546
Phone (608) 314-3660

Other practice location 3

2600 Humes Rd
ste 100
Janesville, WI 53545-0491
Phone (608) 741-2117

Other identifiers 4

IdentifierTypeStateIssuer
43009200MedicaidWI
11011400MedicaidWI
11011426MedicaidWI
43171321MedicaidWI

Other names 1

  • MERCY HOSPITAL JANESVILLE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031113000164 WI Part B Supplier - Clinic/Group Practice 7416860440 Receives reassigned benefits from 1,195 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20071212000610 WI Part A Provider - Hospital 7416860440 Practice locations: Janesville, WI; Whitewater, WI; Milton, WI; Lake Geneva, WI; Evansville, WI; Elkhorn, WI; Edgerton, WI; Delavan, WI…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093768962. Details of each certification follow.

Hospital certification: CCN 520066

Legal name
MERCY HEALTH SYSTEM CORPORATION
Doing business as
MERCY HOSPITAL JANESVILLE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 24, 2021
Beds
240
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 4, 1906 in WI
Enrollment address
1000 Mineral Point Ave
Janesville, WI 53548-2940
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 13

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

View all 13

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercy Health System CorpCCN 520066 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Dave L Syverson Individual Corporate Director Oct 27, 2008
Kathi J Palches Individual W-2 Managing EmployeeFacility Credentialing Coordinator Oct 27, 2008
Ali Olia Individual Corporate OfficerVP Information Systems May 16, 2022
W-2 Managing EmployeeVP Information Systems Nov 1, 2021
Kara Sankey Individual Corporate OfficerVP Operations May 16, 2022
W-2 Managing EmployeeVP Operations Apr 1, 2021
Jennifer a Hallatt Individual Corporate Officer Jan 1, 2012
W-2 Managing Employee Jan 1, 2012
Carlos Arevalo Individual Corporate DirectorBoard Member Oct 16, 2024
Mercy Health Corporation Organization, Rockford, IL Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2016 100%
Operational/Managerial Control Jan 1, 2016 100%
Thomas D Budd Individual Corporate DirectorBoard of Directors - Secretary/Trea Jan 1, 2016
John T Dorsey Individual Corporate OfficerVP & Director of Medical Affairs Aug 20, 2012
W-2 Managing EmployeeVP & Director of Medical Affairs Aug 20, 2012
Katherine a Schack Individual Corporate DirectorBoard of Directors - Vice Chair Mar 22, 2017
Joseph Malas Individual Corporate OfficerCfo Jun 1, 2025
W-2 Managing EmployeeCfo Jun 1, 2025
Joanna Benning Individual Corporate OfficerVP Mar 15, 2015
W-2 Managing EmployeeVP Mar 15, 2015
Robert Brinkerhoff Individual Corporate OfficerVP People & Culture Feb 19, 2024
W-2 Managing EmployeeVP People & Culture Feb 19, 2024
Edward P Cranley Individual Corporate OfficerSenior VP Mercycare Nov 30, 2014
W-2 Managing EmployeeVP Nov 30, 2014
Bradley Olson Individual Corporate OfficerVP Managed Care Sep 25, 2023
W-2 Managing EmployeeVP Managed Care Sep 25, 2023
Mark L Goelzer Individual Corporate OfficerVP & Director of Medical Affairs Jan 1, 2016
Corporate DirectorBoard of Directors Oct 27, 2008
W-2 Managing EmployeeVP & Director of Medical Affairs Jan 1, 2016
Kimberly Scaccia Individual Corporate OfficerVP Revenue Cycle Apr 21, 2020
W-2 Managing EmployeeVP Revenue Cycle Mar 23, 2020
Wesley M Jost Individual Corporate DirectorBoard of Directors Mar 15, 2017
Tyler Killpack Individual Corporate OfficerVP Community Hospitals Aug 1, 2023
W-2 Managing EmployeeVP Community Hospitals Aug 1, 2023
Amy Whitaker Individual Corporate OfficerVP Supply Chain Mar 15, 2023
W-2 Managing EmployeeVP Supply Chain Aug 1, 2022
Thomas R Pool Individual Corporate DirectorBoard of Directors - Chair Oct 27, 2008
Ladd Udy Individual Corporate OfficerVP Value Based Care & Pop Health Nov 10, 2018
W-2 Managing EmployeeVP Value Based Care & Pop Health Nov 10, 2018
Javon R Bea Individual Corporate OfficerPresident and Ceo Oct 27, 1982
Corporate Director Oct 27, 2008
W-2 Managing Employee Oct 27, 2008

Owners & managing parties with NPI records 2

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

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 920

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 920

Affiliated clinicians 475

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

View all 475

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1093768962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 Mineral Point Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535482970",
            "country_code": "US",
            "telephone_number": "608-756-5555",
            "fax_number": "608-756-0174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Deerfield Drive",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "53546",
            "country_code": "US",
            "telephone_number": "608-314-3660",
            "fax_number": "608-314-3661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Humes Rd",
            "address_2": "ste 100",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535450491",
            "country_code": "US",
            "telephone_number": "608-741-2117",
            "fax_number": "608-758-5761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERCY HEALTH SYSTEM CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH CORPORATION",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "MALAS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "815-971-6738"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "310800",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "WI",
            "license": "310800",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "310-800",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WI",
            "license": "310800",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "310800",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "310-800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43009200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11011400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11011426",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43171321",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY HOSPITAL JANESVILLE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MERCY HOSPITAL JANESVILLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.