St. Camillus Health Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3074 Issued in WI

Legal business name

ST. CAMILLUS HEALTH CENTER, INC.

Practice address

10101 W Wisconsin Ave
Wauwatosa, WI 53226-4814

Phone

(414) 258-1814

Fax

(414) 259-7999

NPI assigned

Dec 13, 2006

Last updated

Dec 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Rick Lee Johnson

Title

Ceo

Phone

(414) 258-1814

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609937788. Details of each certification follow.

• CCN 525382 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525382

Legal name

ST. CAMILLUS HEALTH CENTER, INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1985

Last certification

Apr 14, 2025

Beds

50

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

May 9, 1997 in WI

Enrollment address

10101 W Wisconsin Ave
Wauwatosa, WI 53226-4861

Nursing home name

ST CAMILLUS HEALTH CENTER

Other NPIs with the same Medicare PAC ID 2

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

• St. Camillus Health Center, Inc.

  dba St. Camillus Home Health

  • Community Based Hospice Care Agency
  • Wauwatosa, WI
  • NPI 1366690679

  6305839952

  Same PAC ID
• St. Camillus Health Center, Inc.

  dba Camillus Cares Home Health Agency

  • Home Health Agency
  • Wauwatosa, WI
  • NPI 1407922776

  6305839952

  Same PAC ID

Listed as

St Camillus Health CenterCCN 525382 · All quality measures

Overall star rating

2 of 5

Health inspections

1 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Apr 1, 1985

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5042.3 residents per day on average

Penalties (3 years)

2Fines totaling $65,881

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Camillus Cares Home Health Agency3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• St. Camillus Health Center, Inc.

  dba St. Camillus Home Health

  • Community Based Hospice Care Agency
  • Wauwatosa, WI
  • NPI 1366690679
  NPD tax ID
• St. Camillus Health Center, Inc.

  dba Camillus Cares Home Health Agency

  • Home Health Agency
  • Wauwatosa, WI
  • NPI 1407922776
  NPD tax ID

Locations

All disclosed owners & managing parties 15

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

Affiliated clinicians 2

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

• Mir Ismail Quryshi, MD

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1871506089

  Nursing home

  Care Compare affiliation
• Kathleen B Sawasky, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Milwaukee, WI
  • NPI 1407809130

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1609937788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 W WISCONSIN AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264814",
            "telephone_number": "414-258-1814",
            "fax_number": "414-259-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 W WISCONSIN AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264814",
            "telephone_number": "414-258-1814",
            "fax_number": "414-259-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CAMILLUS HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-258-1814",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20125300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren M Splawn, PHARM.D.
• Sport Clinic of Greater Milwaukee
• St Nicholas Health Institute SC
• St. Camillus Health Center, Inc. (St. Camillus Home Health)
• St. Camillus Health Center, Inc. (Camillus Cares Home Health Agency)
• St. Charles Youth & Family Services
• St. Joseph's Emergency Physicians, LLP
• Sta Home Healthcare LLC.
• Ellen A Stabelfeldt, M.D.
• Brady Stadler, PT, DPT

• Skilled Nursing Facility in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.