St. Joseph'S Health Services, Inc.
Organization Active NPI Clinic/Center · Hillsboro, WI
NPI 1104031798 · NPPES record last updated Jul 22, 2011
Key facts
- NPI
- 1104031798
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ST. JOSEPH'S HEALTH SERVICES, INC.
- Practice address
- 400 Water Ave
Hillsboro, WI 54634-9054 - Phone
- (608) 489-8280
- Fax
- (608) 489-8189
- NPI assigned
- May 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Pamela K Dewitt
- Title
- Cfo
- Phone
- (608) 489-8103
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 4
Practitioners 314
-
Mateen Fatima Abidi, M.D
-
Raju G Ailiani, MD
-
Keith Edward Baynes, M.D.
-
Marcus William Bickford, M.D.
-
William Adam Bishop, M.D.
-
Carrie L Brilowski, APNP
-
Christina M Brooks, MSW APSW
-
Ward M Brown, MD
-
Ross Michael Cerniglia, M.D.
-
Zachary Ronald Clements, D.O.
-
Christine A Dean, LCSW
-
Murray Sean Donovan, M.D.
-
Patricia Jean Fronk, NURSE PRACTITIONER
-
Michelle Gardner, APNP
-
Kayla J Gilman, NP
-
Wah Wah Htun, M.D
-
Jamal Janjua, M.D
-
Darren Knox, M.D.
-
Benny Kusuma, MD
-
Jordan L Ludwigson, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040615000273 | WI | Part B Supplier - Clinic/Group Practice | 3971586439 |
Receives reassigned benefits from 307 practitioners 4 other NPIs on this enrollment Practice locations: Wonewoc, WI; Whitehall, WI; Viroqua, WI; Prairie Du Chien, WI; Onalaska, WI; Mequon, WI; Madison, WI; La Crosse, WI… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
400 Water Ave
Hillsboro, WI 54634-9054
Mailing address
PO Box 527
Hillsboro, WI 54634-0527
Phone (608) 489-8280
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78B97J0 | Other | WI | ATRIUM COMMERCIAL |
| P10 | Other | WI | DEAN HEALTH PLAN |
| 11007410 | Medicaid | WI |
Other names
- St. Joseph's Health Services - Hillsboro Clinic
Other providers in Hillsboro, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.