Susan Kees Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

707-023 Issued in WI

Practice address

251 E Cottage Grove Rd
Cottage Grove, WI 53527-9619

Phone

(608) 839-3515

NPI assigned

May 3, 2006

Last updated

Nov 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wildwood Family Clinic SCGroup PAC ID 9537137484, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary's Hospital - Madison Hospital, Madison, WI, CCN 520083
• University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Wildwood Family Clinic, SC

  • Family Medicine Physician
  • Cottage Grove, WI
  • NPI 1225115124
  Medicare reassignment Care Compare group
• St. Marys Dean Ventures Inc.

  • Clinic/Center
  • Baraboo, WI
  • NPI 1811944093
  NPD
• Dean Health Systems, Inc,

  dba Dean Clinic-Beaver Dam Family & Sports Orthopedic Center

  • Durable Medical Equipment & Medical Supplies
  • Beaver Dam, WI
  • NPI 1336425016
  NPD (past)

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

• SSM Health Care of Wisconsin, Inc.

  dba SSM Health St. Mary's Hospital-Madison

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1467410902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E COTTAGE GROVE RD",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535279619",
            "telephone_number": "608-839-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E COTTAGE GROVE RD",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535279619",
            "telephone_number": "608-839-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEES JOHNSON",
        "first_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-11-02",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "707-023",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "707-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "7217",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skeesjohnson260897@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "skeesjohnson260897@direct-ehr-ssmhc.com",
            "address_1": "251 E Cottage Grove Rd",
            "city": "Cottage Grove",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535279619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "251 E Cottage Grove Rd",
            "city": "Cottage Grove",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535279619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Margaret Ann Hojem, PT
• Daniel Reese Hunter, RN
• Michelet Jean-Charles
• Emily Jones, RN
• Megan Sue Kaddatz
• Jason C Kindschi, DC
• Kathleen Anne Knipfer, P.A. C.
• Kayla Dawn Koch, RN
• Dylan Steven Ledford, DO
• Melanie Leistikow, MS

• Medical Physician Assistant in Cottage Grove, WI
• Providers in Cottage Grove, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.