NPIMap

Organization Active NPI

SSM Health Care of Wisconsin, Inc.

Doing business as SSM Health St. Mary's Hospital - Janesville

  • General Acute Care Hospital
  • Janesville, WI
National Provider Identifier
1194004408
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
SSM HEALTH CARE OF WISCONSIN, INC.
Doing business as
SSM Health St. Mary's Hospital - Janesville
Practice address
3400 E Racine St
Janesville, WI 53546-2344
Phone
(608) 373-8000
Fax
(608) 314-8878
NPI assigned
Aug 4, 2011
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Joseph R Minerath
Title
System Director Gov'T Reimbursement
Phone
(608) 445-2411

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

3400 E Racine St
Janesville, WI 53546-2344

Mailing address

3400 E Racine St
Janesville, WI 53546-2344
Phone (608) 373-8000

Other identifiers 1

IdentifierTypeStateIssuer
100021887MedicaidWI

Other names 1

  • SSM Health St. Mary's Hospital - Janesville Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040212000492 WI Part B Supplier - Clinic/Group Practice 8527977867 Receives reassigned benefits from 34 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baraboo, WI; Janesville, WI; Madison, WI
O20111114000200 WI Part A Provider - Hospital 8527977867 Practice locations: Janesville, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194004408. Details of each certification follow.

Hospital certification: CCN 520208

Legal name
SSM HEALTH CARE OF WISCONSIN INC
Doing business as
SSM HEALTH ST. MARY'S HOSPITAL - JANESVILLE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 30, 2012
Last certification
Jan 30, 2012
Beds
50
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 2012 in WI
Enrollment address
3400E Racine St
Janesville, WI 53546-2344
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 4

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

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
SSM Health St Mary's Hospital - JanesvilleCCN 520208 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

2844 Index Rd
Fitchburg, WI 53713
Phone (608) 229-7979

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Albert John Musa Individual Corporate DirectorDirector Jan 1, 2017
Sue Anderson Individual W-2 Managing EmployeeRegional Ceo Sep 1, 2022
Rhea Emmer Individual Corporate DirectorBoard Member Jan 10, 2018
Theodore D Miller Individual Corporate DirectorBoard Member May 11, 2021
Jennifer Maskel Individual Corporate DirectorBoard Member Jan 1, 2019
Joan a Karsten Individual Corporate DirectorBoard Member May 11, 2021
Wesley Sparkman Individual Corporate DirectorDirector Jan 1, 2017
Gregory Michael Matzke Individual Corporate DirectorDirector Jan 1, 2017
Troy Walker Individual Corporate OfficerDirector of Finance Aug 5, 2015
W-2 Managing EmployeeDirector of Finance Aug 5, 2015
James D Mathers Individual Corporate DirectorDirector Jan 1, 2017
James Walter Scott Fuller Individual Corporate DirectorBoard Member Mar 27, 2020
Joseph Minerath Individual Corporate OfficerSystem Director of Reimbursement Jul 21, 2015
W-2 Managing EmployeeSystem Director of Reimbursement Jul 21, 2015
SSM Health Care Corporation Organization, Saint Louis, MO Non-profit 5% Or Greater Direct Ownership Interest Nov 13, 2011 100%
Mark Allan Covaleski Individual Corporate DirectorDirector Jan 1, 2017
Laura Kaiser Individual Corporate OfficerCeo Jan 1, 2017
Corporate DirectorCeo Jan 1, 2017

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SSM Health Monroe HospitalMonroe, WI, CCN 520028 Hospital 5% Or Greater Indirect Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2018
Jan 1, 2018
Stoughton HospitalStoughton, WI, CCN 521343 Hospital 5% Or Greater Direct Ownership Interest (40%) Feb 6, 2003
Stoughton HospitalStoughton, WI, CCN 52M343 Hospital 5% Or Greater Direct Ownership Interest (40%) Feb 6, 2003
Stoughton Hospital AssociationStoughton, WI, CCN 52Z343 Hospital 5% Or Greater Direct Ownership Interest (40%) Feb 6, 2003
SSM Health Ripon Community HospitalRipon, WI, CCN 521321 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
SSM Health Ripon Community HospitalRipon, WI, CCN 52Z321 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
St Francis HomeFond Du Lac, WI, CCN 525595 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2018
May 21, 2025
SSM Health at Home Home Health - Fond Du LacFond Du Lac, WI, CCN 527113 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
SSM Health at Home Hospice-WisconsinBaraboo, WI, CCN 521522 Hospice 5% Or Greater Direct Ownership Interest (100%) Aug 13, 2018
SSM Health at Home Hospice Fond Du LacFond Du Lac, WI, CCN 521512 Hospice Operational/Managerial Control (100%) Jan 1, 2018
SSM Health at Home Hospice MonroeMonroe, WI, CCN 521523 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Facilities with the same owner 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 94

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 94

Affiliated clinicians 367

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

View all 367

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1194004408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462344",
            "telephone_number": "608-373-8000",
            "fax_number": "608-314-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462344",
            "telephone_number": "608-373-8000",
            "fax_number": "608-314-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF WISCONSIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "MINERATH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR GOV'T REIMBURSEMENT",
        "authorized_official_telephone_number": "608-445-2411"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100021887",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SSM Health St. Mary's Hospital - Janesville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health St. Mary's Hospital - Janesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.