NPIMap

Individual provider Active NPI

Steven E Diebold, MD

  • Emergency Medicine Physician
  • Beloit, WI
National Provider Identifier
1487724019
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
033487 Issued in WI
Practice address
1969 W Hart Rd
Beloit, WI 53511
Phone
(608) 758-7215
Fax
(608) 758-3216
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 033487 WI Primary

Addresses

Primary practice location

1969 W Hart Rd
Beloit, WI 53511

Mailing address

1446 N Randall Ave
Janesville, WI 53545
Phone (608) 758-7215

Other identifiers 1

IdentifierTypeStateIssuer
31924100MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sdiebold259462@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 IL, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080214000346 IL Practitioner - Emergency Medicine 0345323366 Reassigns benefits to 2 organizations
I20101025000517 WI Practitioner - Emergency Medicine 0345323366 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Chicago, Pritzker School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Wisconsin Emergency Associates SCGroup PAC ID 3274561055, 47 clinicians
Swea Fort SCGroup PAC ID 0345774972, 51 clinicians
Stoughton Hospital AssociationGroup PAC ID 7012825706, 66 clinicians

Practice addresses (Care Compare)

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5566

5605 E Rockton Rd
Roscoe, IL 61073-7601
Phone (815) 525-4100

611 Sherman Ave E
Fort Atkinson, WI 53538-1960
Phone (920) 568-5475

900 Ridge St
Stoughton, WI 53589-1864
Phone (608) 873-6611

Hospital & facility affiliations

  • Stoughton Hospital Hospital, Stoughton, WI, CCN 521343
  • Beloit Health System Hospital, Beloit, WI, CCN 520100
  • Edgerton Hospital and Health Services Hospital, Edgerton, WI, CCN 521319
  • Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071

Merit-based Incentive Payment System (MIPS)

Final score
85.73 of 100Reported as group
Quality
87.42
Promoting interoperability
100
Improvement activities
40
Cost
65.02

Merit-based Incentive Payment System (MIPS)

Final score
69.34 of 100Reported as group
Quality
87.81
Promoting interoperability
100
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033487WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edgerton Hospital and Health Services, Inc CurrentSince Mar 19, 2024 Accepting new patients
Edgerton Hospital and Health Services Inc. CurrentSince Oct 1, 2025 Accepting new patients
Stoughton Hospital Association CurrentSince Dec 1, 1998 Accepting new patients
Edgerton Hospital and Health Services CurrentSince Mar 19, 2024 Accepting new patients
Stoughton Hospital Association CurrentSince Jan 1, 2026 Accepting new patients
Beloit Health System Inc CurrentSince Dec 3, 2007 Accepting new patients
Stoughton Hospital Association CurrentSince Dec 1, 1998 Accepting new patients
Southern Wisconsin Emergency Associates SC Emergency Medicine CurrentSince Jan 1, 1993 Accepting new patients
Beloit Health System, Inc CurrentSince Dec 3, 2007 Accepting new patients
Swea Fort SC Emergency Medicine CurrentSince Oct 18, 2024 Accepting new patients
Stoughton Hospital Association Past Accepting new patients

Locations

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

110 Limestone Pass
Ste 103
Cottage Grove, WI 53527

11101 N Sherman Rd
Edgerton, WI 53534
Phone (608) 884-1695

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

1446 N Randall Ave
Janesville, WI 53545
Phone (608) 758-7215

5614 US Highway 51
McFarland, WI 53558
Phone (608) 838-8242

831 Arthur Dr
Milton, WI 53563
Phone (608) 868-3526

990 Janesville St
Ste L
Oregon, WI 53575

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

Organizations & group practices 11

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 8

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1487724019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 N RANDALL AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "53545",
            "telephone_number": "608-758-7215",
            "fax_number": "608-758-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "53511",
            "telephone_number": "608-758-7215",
            "fax_number": "608-758-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEBOLD",
        "first_name": "STEVEN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "033487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31924100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdiebold259462@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sdiebold259462@direct-ehr-ssmhc.com",
            "address_1": "1223 E Main St",
            "city": "Perry",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634621410",
            "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": "1223 E Main St",
            "city": "Perry",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634621410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.