NPIMap

Organization Active NPI

Mercy Health System Corporation

Doing business as Mercy Walworth Hospital and Medical Center

  • Prosthetic/Orthotic Supplier
  • Lake Geneva, WI
National Provider Identifier
1710124698
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MERCY HEALTH SYSTEM CORPORATION
Doing business as
Mercy Walworth Hospital and Medical Center
Practice address
N2950 State Road 67
RM G218
Lake Geneva, WI 53147-2655
Phone
(262) 245-0535
NPI assigned
Jan 14, 2009
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Joseph D Malas
Title
Cfo
Phone
(815) 971-6738

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 310800 WI
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

N2950 State Road 67
RM G218
Lake Geneva, WI 53147-2655

Mailing address

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

Other names 1

  • MERCY WALWORTH HOSPITAL AND MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170303000850 WI DME Supplier - Multi-Specialty - Physician 7416860440 Practice locations: Lake Geneva, WI

Other NPIs with the same Medicare PAC ID 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Dedham Medical Associat16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations (25 of 27)

2401 Harnish Dr
Algonquin, IL 60102
Phone (847) 458-5440

2401 Harnish Dr
Ste 101
Algonquin, IL 60102
Phone (224) 704-0317

2430 Esplanade Dr
Ste A
Algonquin, IL 60102
Phone (847) 854-8000

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

390 E Congress Pkwy
Crystal Lake, IL 60014
Phone (779) 284-0347

415 E Congress Pkwy
Crystal Lake, IL 60014
Phone (779) 220-5600

415 E Congress Pkwy
Ste 415A
Crystal Lake, IL 60014

415 E Congress Pkwy
Ste 5
Crystal Lake, IL 60014

1000 N Hayes St
Harvard, IL 60033
Phone (815) 943-2975

1819 N Division St
Harvard, IL 60033
Phone (815) 943-2071

901 Grant St
Ste E
Harvard, IL 60033

3922 Mercy Dr
Ste 101
McHenry, IL 60050

3922 Mercy Dr
Ste E
McHenry, IL 60050

406 Front St
McHenry, IL 60050
Phone (847) 381-0388

3600 E State St
Ste 328
Rockford, IL 61108
Phone (815) 397-0410

3849 N Perryville Rd
Rockford, IL 61114
Phone (815) 654-2486

942 W State St
Ste 500
Sycamore, IL 60178

1060 Lake Ave
Woodstock, IL 60098

2310 1st Center Ave
Ste E
Brodhead, WI 53520

1000 Mineral Point Ave
Ste E
Janesville, WI 53548

1010 N Washington St
Ste 101
Janesville, WI 53548
Phone (608) 741-2430

1010 N Washington St
Ste E
Janesville, WI 53548

3524 E Milwaukee St
Ste E
Janesville, WI 53546

557 N Washington St
Ste E
Janesville, WI 53548

2500 Overlook Ter
Madison, WI 53705
Phone (608) 280-7084

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1710124698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2950 STATE ROAD 67",
            "address_2": "RM G218",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472655",
            "telephone_number": "262-245-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH SYSTEM CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH CORPORATION",
        "enumeration_date": "2009-01-14",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "MALAS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "815-971-6738"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "310800",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY WALWORTH HOSPITAL AND MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MERCY WALWORTH HOSPITAL AND MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.