Active NPI
Kelsey L Shean, MD
- Family Medicine Physician
- Oregon, WI
National Provider Identifier
1124513767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 77470-20
- Practice address
- 753 N Main St
Oregon, WI 53575-1003 - Phone
- (608) 835-2222
- Fax
- (608) 835-1090
- NPI assigned
- Jun 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125.072869 | IL | |
| Internal Medicine Physician | 207R00000X | 77470-20 | WI | |
| Pediatrics Physician | 208000000X | 77470-20 | WI | |
| Family Medicine Physician | 207Q00000X | 77470-20 | WI | Primary |
Addresses
Primary practice location
753 N Main St
Oregon, WI 53575-1003
Mailing address
753 N Main St
Oregon, WI 53575-1003
Phone (608) 835-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124513767 | Medicaid | WI |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
753 N Main St
Oregon, WI 53575-1003
Phone (608) 835-2222
Hospital & facility affiliations
- SSM Health at Home Home Health-Wisconsin
- SSM Health at Home Monroe
- Agrace Hospicecare
- SSM Health at Home Hospice
- SSM Health St Mary'S Hospital - Madison
- Stoughton Hospital
- University of Wi Hospitals & Clinics Authority
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.072869 | IL | MD | Internal Medicine Physician |
| 77470-20 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc. | Current | Accepting new patients | |
| Dean Health Systems, Inc | Family Medicine | Current | Accepting new patients |
Locations
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
753 N Main St
Oregon, WI 53575
Phone (608) 835-2222
Interoperability endpoints
- kshean435308@direct-ehr-ssmhc.com
Organizations & group practices 2
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.
-
- Durable Medical Equipment & Medical Supplies
- Portage, WI
- NPI 1427085679
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Fitchburg, WI
- NPI 1861503534
-
- Home Health Agency
- Madison, WI
- NPI 1275686404
-
- Community Based Hospice Care Agency
- Baraboo, WI
- NPI 1306990221
-
- General Acute Care Hospital
- Madison, WI
- NPI 1184621211
-
- Critical Access Hospital
- Stoughton, WI
- NPI 1679558647
-
- Home Health Agency
- Monroe, WI
- NPI 1295830628
-
- General Acute Care Hospital
- Madison, WI
- NPI 1922043744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1124513767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "753 N MAIN ST",
"city": "OREGON",
"state": "WI",
"postal_code": "535751003",
"telephone_number": "608-835-2222",
"fax_number": "608-835-1090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "753 N MAIN ST",
"city": "OREGON",
"state": "WI",
"postal_code": "535751003",
"telephone_number": "608-835-2222",
"fax_number": "608-835-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEAN",
"first_name": "KELSEY",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125.072869",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "77470-20",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "77470-20",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "77470-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124513767",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oregon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.