Individual provider Active NPI

Sarah T Hermsdorf, PA-C

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1508815820
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1733 Issued in WI
Practice address
700 S Park St
Dean & St. Mary'S Outpatient Center
Madison, WI 53715-1830
Phone
(608) 260-2900
NPI assigned
May 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1733-023 WI
Surgical Physician Assistant 363AS0400X 1733-023 WI
Physician Assistant 363A00000X 1733 WI Primary

Addresses

Primary practice location

700 S Park St
Dean & St. Mary'S Outpatient Center
Madison, WI 53715-1830

Mailing address

700 S Park St
Dean & St. Mary'S Outpatient Center
Madison, WI 53715-1830
Phone (608) 260-2900

Other identifiers 1

IdentifierTypeStateIssuer
1508815820MedicaidWI

Other names 1

  • Sarah T Wagner Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address shermsdorf259757@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008001032 WI Practitioner - Physician Assistant 2365401825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Hospital & facility affiliations

  • SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
  • SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1733-023WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Jun 24, 2004 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jun 24, 2004 Accepting new patients

Locations

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

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

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

100 N Main St
Richland Ctr, WI 53581
Phone (608) 647-8995

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 2

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1508815820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "DEAN & ST. MARY'S OUTPATIENT CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "DEAN & ST. MARY'S OUTPATIENT CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMSDORF",
        "first_name": "SARAH",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-06",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1733-023",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1733-023",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508815820",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shermsdorf259757@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "shermsdorf259757@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St",
            "address_2": "Dean & St. Mary's Outpatient Center",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "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": "700 S Park St",
            "address_2": "Dean & St. Mary's Outpatient Center",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "WAGNER",
            "middle_name": "T",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.