Vasilisa Mironovich, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

60837-20 Issued in WI

Practice address

2817 New Pinery Rd
Portage, WI 53901-9240

Phone

(608) 742-4131

Fax

(608) 745-6393

NPI assigned

Mar 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aveanna Home Health Home health agency, Baraboo, WI, CCN 527332
• Agrace Hospicecare Hospice, Madison, WI, CCN 521505
• Aspirus Divine Savior Hospital Hospital, Portage, WI, CCN 520041
• University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

Merit-based Incentive Payment System (MIPS)

Final score

91.7 of 100Reported as group

Quality

91.14

Promoting interoperability

100

Improvement activities

40

Cost

77.5

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vmironovich159964@direct.aspirus.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Divine Savior Healthcare, Inc.

  dba Aspirus Divine Savior Hospital

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Divine Savior Healthcare, Inc.

  dba Aspirus Portage Clinic

  • Rural Health Clinic/Center
  • Portage, WI
  • NPI 1386154417
  NPD
• Divine Savior Healthcare, Inc.

  dba Aspirus Divine Savior Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portage, WI
  • NPI 1275598948
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Agrace Hospicecare, Incorporated

  • Community Based Hospice Care Agency
  • Fitchburg, WI
  • NPI 1861503534
  Care Compare affiliation
• Divine Savior Healthcare, Inc.

  dba Aspirus Divine Savior Hospital

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Care Compare affiliation
• Recover Health of Wisconsin, Inc.

  dba Aveanna Home Health

  • Home Health Agency
  • Madison, WI
  • NPI 1568469070
  Care Compare affiliation
• University of Wisconsin Hospitals and Clinics Authority

  dba University of Wisconsin Hospital and Clinics

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1922043744
  Care Compare affiliation

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1295024479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131",
            "fax_number": "608-745-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131",
            "fax_number": "608-745-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRONOVICH",
        "first_name": "VASILISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "60837-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MH Health Care Services, PC
• Midstate Medical Express
• Cheryl Millard, LCSW
• Jocelyn R Miller, PHD
• Jennifer L Millholland, M.S.,CCC/SLP
• Daniel Joseph Moore, PHARMD
• Rachel Morris
• Robyn Morris, CCC SLP
• Bennett F Mortensen, MS, LPC
• Bailey A Moskowitz, MS

• Family Medicine Physician in Portage, WI
• Providers in Portage, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.

Verify at the official NPI Registry.