NPIMap

Organization Active NPI

SSM Health Care of Wisconsin, Inc

Doing business as SSM Health St. Mary's Hospital - Madison

  • Land Ambulance
  • Madison, WI
National Provider Identifier
1699789362
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
71 Issued in WI
Legal business name
SSM HEALTH CARE OF WISCONSIN, INC
Doing business as
SSM Health St. Mary's Hospital - Madison
Practice address
700 S. Park St.
Madison, WI 53715-1830
Phone
(608) 251-6100
Fax
(608) 258-5221
NPI assigned
Jul 28, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Joseph Minerath
Title
System Dir of Reimbursement
Phone
(608) 258-6891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 71 WI Primary

Addresses

Primary practice location

700 S. Park St.
Madison, WI 53715-1830

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
41347600MedicaidWI

Other names 1

  • SSM Health St. Mary's Hospital - Madison Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

National Provider Directory

National Provider Directory
Tax ID family
Rocco J Fiordelisi MD22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1699789362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S. PARK ST.",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-251-6100",
            "fax_number": "608-258-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S. PARK ST.",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-251-6100",
            "fax_number": "608-258-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF WISCONSIN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "MINERATH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "SYSTEM DIR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "608-258-6891"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "71",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41347600",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SSM Health St. Mary's Hospital - Madison",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health St. Mary's Hospital - Madison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.