NPIMap

Organization Active NPI

Dean Health Systems, Inc.

Doing business as SSM Health Dean Medical Group - Oregon

  • Durable Medical Equipment & Medical Supplies
  • Oregon, WI
National Provider Identifier
1720096332
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.
Doing business as
SSM Health Dean Medical Group - Oregon
Practice address
753 N Main St
Oregon, WI 53575-1003
Phone
(608) 835-2222
NPI assigned
Aug 3, 2006
Last updated
Aug 3, 2020By the provider in NPPES
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 NU Primary

Addresses

Primary practice location

753 N Main St
Oregon, WI 53575-1003

Mailing address

753 N Main St
Oregon, WI 53575-1003
Phone (608) 835-2222

Other identifiers 1

IdentifierTypeStateIssuer
1053358846MedicaidWI

Other names 1

  • SSM Health Dean Medical Group - Oregon Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930093182 WI DME Supplier - Multi-Specialty - Physician 7012827983 Practice locations: Oregon, 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
52D0039579SSM Health Dean Medical Group - Oregon753 N Main St, Oregon, WI 53575ComplianceDec 20, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

753 N Main St
Oregon, WI 53575
Phone (608) 835-2222

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1720096332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535751003",
            "telephone_number": "608-835-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535751003",
            "telephone_number": "608-835-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "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": "NU",
            "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 - Oregon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health Dean Medical Group - Oregon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oregon, 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.