Individual provider Active NPI

Orest I Kostelyna, MD

  • Internal Medicine Physician
  • Madison, WI
National Provider Identifier
1326093691
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31059-020 Issued in WI
Practice address
1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone
(608) 252-8000
Fax
(608) 252-8233
NPI assigned
May 24, 2006
Last updated
May 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31059-020 WI Primary

Addresses

Primary practice location

1211 Fish Hatchery Rd
Madison, WI 53715-1909

Mailing address

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

Other identifiers 1

IdentifierTypeStateIssuer
1326093691MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address okostelyna261101@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100423000872 WI Practitioner - Internal Medicine 6608903570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31059-020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Internal Medicine CurrentSince Jul 1, 1990 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jul 1, 1990 Accepting new patients

Locations

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: okostelyna261101@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1326093691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-252-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-252-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTELYNA",
        "first_name": "OREST",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "31059-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326093691",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "okostelyna261101@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "okostelyna261101@direct-ehr-ssmhc.com",
            "address_1": "1211 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1211 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.