NPIMap

Organization Active NPI

Mile Bluff Medical Center Inc

Doing business as Mile Bluff ER/UC Providers

  • Emergency Medicine Physician
  • Mauston, WI
National Provider Identifier
1609912005
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MILE BLUFF MEDICAL CENTER INC
Practice address
1050 Division St
Mauston, WI 53948-1931
Phone
(608) 847-6161
Fax
(608) 847-2079
NPI assigned
Jan 30, 2007
Last updated
Apr 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MILE BLUFF MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Authorized official

Name
Thomas Kaminski
Title
VP/Cfo
Phone
(608) 847-1452

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Urgent Care Clinic/Center 261QU0200X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

1050 Division St
Mauston, WI 53948-1931

Mailing address

1050 Division St
Mauston, WI 53948-1931
Phone (608) 847-6161

Other practice location 1

406 Gateway Ave
Mauston, WI 53948-1401
Phone (608) 847-2961

Other names 1

  • Mile Bluff ER/UC Providers Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031205000618 WI Part B Supplier - Clinic/Group Practice 8527971399 Receives reassigned benefits from 205 practitioners
2 other NPIs on this enrollment
Practice locations: Wisconsin Dells, WI; Tomah, WI; Reedsburg, WI; New Lisbon, WI; Necedah, WI; Mauston, WI; Friendship, WI; Elroy, WI

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Mile Bluff Medical Ctr Inc

Practitioners & affiliated clinicians

Practitioners 215

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 215

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1609912005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931",
            "telephone_number": "608-847-6161",
            "fax_number": "608-847-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931",
            "telephone_number": "608-847-6161",
            "fax_number": "608-847-2079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 Gateway Ave",
            "address_purpose": "LOCATION",
            "city": "Mauston",
            "state": "WI",
            "postal_code": "539481401",
            "country_code": "US",
            "telephone_number": "608-847-2961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MILE BLUFF MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILE BLUFF MEDICAL CENTER INC",
        "enumeration_date": "2007-01-30",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "KAMINSKI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "608-847-1452"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mile Bluff ER/UC Providers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mile Bluff ER/UC Providers",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mauston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.