NPIMap

Organization Active NPI

Dean Health Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Waunakee, WI
National Provider Identifier
1619984713
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DEAN HEALTH SYSTEMS, INC.
Practice address
1300 S Century Ave
Waunakee, WI 53597
Phone
(608) 849-4315
Fax
(608) 850-1606
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
Amy J Grinnell
Title
Vice President - Finance
Phone
(608) 260-3586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1300 S Century Ave
Waunakee, WI 53597

Mailing address

1300 S Century Ave
Waunakee, WI 53597
Phone (608) 849-4315

Other identifiers 1

IdentifierTypeStateIssuer
1053358846MedicaidWI

Other names 1

  • SSM Health Dean Medical Group - Waunakee Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930099437 WI DME Supplier - Multi-Specialty - PhysicianDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 7012827983 Practice locations: Waunakee, WI

Other NPIs with the same Medicare PAC ID 20

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

View all 20

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
52D0393253SSM Health Dean Medical Group - Waunakee1300 S Century Ave, Waunakee, WI 53597ComplianceOct 14, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Dean Retail Services Inc1300 S Century Ave, Waunakee, WI 53597-2386(608) 850-1650 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2013
Dean Health Systems Inc1300 S Century Ave, Waunakee, WI 53597-2386(608) 849-4315 Canes and/or Crutches|Urological Supplies Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1619984713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S CENTURY AVE",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "53597",
            "telephone_number": "608-849-4315",
            "fax_number": "608-850-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S CENTURY AVE",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "53597",
            "telephone_number": "608-849-4315",
            "fax_number": "608-850-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "GRINNELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT - FINANCE",
        "authorized_official_telephone_number": "608-260-3586"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053358846",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Dean Medical Group - Waunakee",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health Dean Medical Group - Waunakee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waunakee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.