Individual provider Active NPI

Jean Christina Carstensen, M.D.

  • Family Medicine Physician
  • Columbus, WI
National Provider Identifier
1467655613
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1222 Issued in WI
Practice address
1513 Park Ave FL 1
Columbus, WI 53925-1793
Phone
(920) 623-9611
Fax
(920) 623-1787
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301086833 MI
Pediatrics Physician 208000000X 4301086833 MI
Family Medicine Physician 207Q00000X 1222 WI Primary

Addresses

Primary practice location

1513 Park Ave FL 1
Columbus, WI 53925-1793

Mailing address

1513 Park Ave FL 1
Columbus, WI 53925-1793
Phone (920) 623-9611

Other practice location 1

1051 N Canton Center Rd
Canton, MI 48187-5097
Phone (734) 844-5400

Other identifiers 1

IdentifierTypeStateIssuer
1467655613MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address jcarstensen399390@direct-ehr-ssmhc.com Direct

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
I20210812001383 WI Practitioner - Internal Medicine 6002901964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 2003
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)

1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200

Hospital & facility affiliations

  • SSM Health at Home Home Health-Wisconsin Home health agency, Madison, WI, CCN 527184
  • Columbus Community Hospital Hospital, Columbus, WI, CCN 521338
  • SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301086833MIMDInternal Medicine Physician
1222WIMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Family Medicine CurrentSince Aug 2, 2021 Accepting new patients
Dean Health Systems, Inc. CurrentSince Aug 2, 2021 Accepting new patients

Locations

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

1513 Park Ave
Fl 1
Columbus, WI 53925
Phone (920) 623-9611

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: jcarstensen402978@direct.med.umich.edu
  • Direct secure messaging: jcarstensen399390@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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1467655613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 PARK AVE FL 1",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251793",
            "telephone_number": "920-623-9611",
            "fax_number": "920-623-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 PARK AVE FL 1",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251793",
            "telephone_number": "920-623-9611",
            "fax_number": "920-623-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 N Canton Center Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481875097",
            "country_code": "US",
            "telephone_number": "734-844-5400",
            "fax_number": "734-844-5298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSTENSEN",
        "first_name": "JEAN",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301086833",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301086833",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "1222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467655613",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "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": "1513 Park Ave Fl 1",
            "city": "Columbus",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539251793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcarstensen399390@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jcarstensen399390@direct-ehr-ssmhc.com",
            "address_1": "1513 Park Ave Fl 1",
            "city": "Columbus",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539251793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, WI

Sources for this page

Verify at the official NPI Registry.