NPIMap

Organization Active NPI

SSM Health Care of Wisconsin Inc

  • Internal Medicine Physician
  • Baraboo, WI
National Provider Identifier
1730160011
Registry record updated Jul 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SSM HEALTH CARE OF WISCONSIN INC
Practice address
707 14TH St
Baraboo, WI 53913-1539
Phone
(608) 356-1400
NPI assigned
Nov 14, 2005
Last updated
Jul 18, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH ST CLARE HOSPITAL-BARABOOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 18, 2026

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

Authorized official

Name
Amy J Grinnell
Title
Director of Finance
Phone
(608) 229-7885

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Internal Medicine Physician 207R00000X Primary
Pediatrics Physician 208000000X
Hospitalist Physician 208M00000X
Registered Respiratory Therapist 227900000X
Physician Assistant 363A00000X
Acute Care Nurse Practitioner 363LA2100X
Family Nurse Practitioner 363LF0000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Addresses

Primary practice location

707 14TH St
Baraboo, WI 53913-1539

Mailing address

707 14TH St
Baraboo, WI 53913-1539
Phone (608) 356-1400

Other identifiers 4

IdentifierTypeStateIssuer
32880600MedicaidWI
1009390OtherWIPHYS PLUS PROV #
391023846028OtherWIBLUE CROSS PROV #
391023846OtherWICOMMERCIAL INS PROV #

Other names 1

  • Medical Providers Other name

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001345 WI Part B Supplier - Clinic/Group Practice 8527977867 Receives reassigned benefits from 56 practitioners
Practice locations: Baraboo, WI

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Part of
Rocco J Fiordelisi MD

Ownership & related parties

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SSM Health Monroe HospitalMonroe, WI, CCN 520028 Hospital 5% Or Greater Indirect Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2018
Jan 1, 2018
Stoughton HospitalStoughton, WI, CCN 521343 Hospital 5% Or Greater Direct Ownership Interest (40%) Feb 6, 2003
Stoughton HospitalStoughton, WI, CCN 52M343 Hospital 5% Or Greater Direct Ownership Interest (40%) Feb 6, 2003
Stoughton Hospital AssociationStoughton, WI, CCN 52Z343 Hospital 5% Or Greater Direct Ownership Interest (40%) Feb 6, 2003
SSM Health Ripon Community HospitalRipon, WI, CCN 521321 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
SSM Health Ripon Community HospitalRipon, WI, CCN 52Z321 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
St Francis HomeFond Du Lac, WI, CCN 525595 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2018
May 21, 2025
SSM Health at Home Home Health - Fond Du LacFond Du Lac, WI, CCN 527113 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018
SSM Health at Home Hospice-WisconsinBaraboo, WI, CCN 521522 Hospice 5% Or Greater Direct Ownership Interest (100%) Aug 13, 2018
SSM Health at Home Hospice Fond Du LacFond Du Lac, WI, CCN 521512 Hospice Operational/Managerial Control (100%) Jan 1, 2018
SSM Health at Home Hospice MonroeMonroe, WI, CCN 521523 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2018

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Practitioners & affiliated clinicians

Practitioners 71

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.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784332800000",
    "number": "1730160011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 14TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131539",
            "telephone_number": "608-356-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 14TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131539",
            "telephone_number": "608-356-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF WISCONSIN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH ST CLARE HOSPITAL-BARABOO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2026-07-18",
        "certification_date": "2026-07-18",
        "status": "A",
        "authorized_official_last_name": "GRINNELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "608-229-7885"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32880600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYS PLUS PROV #",
            "identifier": "1009390",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROV #",
            "identifier": "391023846028",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INS PROV #",
            "identifier": "391023846",
            "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",
            "affiliationName": "Cobius Healthcare Solutions",
            "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": "Medical Providers",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Medical Providers",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.