NPIMap

Organization Active NPI

Sacred Heart Rehabilitation Institute, Inc.

Doing business as Ascension Sacred Heart Rehabilitation Hospital

  • Rehabilitation Hospital
  • Mequon, WI
National Provider Identifier
1508920356
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
165 Issued in WI
Legal business name
SACRED HEART REHABILITATION INSTITUTE, INC.
Doing business as
Ascension Sacred Heart Rehabilitation Hospital
Practice address
13111 N Port Washington Rd FL 2
Mequon, WI 53097-2416
Phone
(414) 585-6884
NPI assigned
Dec 19, 2006
Last updated
Jul 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Susan Dwyer
Title
Cfo
Phone
(414) 465-3093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 165 WI Primary

Addresses

Primary practice location

13111 N Port Washington Rd FL 2
Mequon, WI 53097-2416

Mailing address

PO Box 773446
Chicago, IL 60677-3446
Phone (262) 292-0400

Other practice location 1

2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-6884

Other identifiers 1

IdentifierTypeStateIssuer
11020000MedicaidWI

Other names 1

  • Ascension Sacred Heart Rehabilitation Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202001121 WI Part A Provider - Hospital 5890688113 Practice locations: Milwaukee, WI; Mequon, WI; Glendale, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508920356. Details of each certification follow.

Hospital certification: CCN 523025

Legal name
SACRED HEART REHABILITATION INSTITUTE INC
Doing business as
ASCENSION SACRED HEART REHABILITATION HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Jul 1, 1984
Last certification
Sep 23, 2003
Beds
81
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Apr 8, 1955 in WI
Enrollment address
13111 N Port Washington Rd
FL 2
Mequon, WI 53097-2416
Other Hospital Practice Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Ascension Sacred Heart Rehabilitation HospitalCCN 523025 · All quality measures
Ownership
Non-profit
Certified
Jul 1, 1984
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0904432Ascension Sacred Heart Rehabilitation Hospital13111 N Port Washington Rd, Mequon, WI 53097Certificate of waiverJan 20, 2028

National Provider Directory

National Provider Directory

Locations

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph P Regan Individual Corporate DirectorBoard Member Jul 1, 2023
Matthew Mokrohisky Individual Corporate DirectorBoard of Directors Jan 1, 2024
Robert Vanhimbergen Individual Corporate DirectorBoard Member Jul 1, 2017
Mark Catherall Individual Corporate DirectorBoard of Directors Jan 1, 2024
Robin Barten Individual W-2 Managing EmployeeNet Rev MGMT-MGR Nov 1, 2024
Bhagath Siripurapu Individual Corporate DirectorBoard of Directors Jan 1, 2024
Jonathan H Berkoff Individual Corporate DirectorBoard Member Jul 1, 2023
Michael McCullough Individual Corporate OfficerCfo Oct 21, 2024
W-2 Managing Employee Oct 21, 2024
Operational/Managerial ControlCfo Oct 21, 2024
Stephanie Hietpas Individual W-2 Managing EmployeeNet Rev MGMT-MGR Nov 1, 2024
Rexanne R Braun Individual W-2 Managing EmployeeEnrollment Coordinator Jul 1, 2019
Lynne Briggs Individual Corporate DirectorBoard Member Jul 1, 2017
Ascension Health Organization, Saint Louis, MO Corporation, Non-profit Operational/Managerial Control Nov 1, 1999
John Joyce Individual Corporate DirectorBoard Member Apr 26, 2022
W-2 Managing EmployeeHospital President Apr 26, 2022
Operational/Managerial ControlHospital President Apr 26, 2022
Jerry Suriano Individual Corporate DirectorBoard of Directors Jan 1, 2024
Ascension Wisconsin, Inc Organization, Glendale, WI Corporation, Non-profit Operational/Managerial Control Jun 30, 2017 100%
Kaye-Eileen Willard Individual Corporate DirectorBoard Member Jan 1, 2020

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 159

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 159

Practitioners & affiliated clinicians

Practitioners 117

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 117

Affiliated clinicians 13

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1508920356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 773446",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606773446",
            "telephone_number": "262-292-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 N PORT WASHINGTON RD FL 2",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972416",
            "telephone_number": "414-585-6884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2323 N Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532114508",
            "country_code": "US",
            "telephone_number": "414-585-6884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SACRED HEART REHABILITATION INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "414-465-3093"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "WI",
            "license": "165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11020000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Sacred Heart Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.