Individual provider Active NPI

Anthony Jay Callisto, MD

  • Emergency Medicine Physician
  • Madison, WI
National Provider Identifier
1750424115
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
50465-20 Issued in WI
Practice address
700 S Park St
Madison, WI 53715-1830
Phone
(608) 251-6100
Fax
(608) 826-2710
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01060968A IN
Emergency Medicine Physician 207P00000X 50465-20 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 practice location 1

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-4600

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address acallisto269750@direct-ehr-ssmhc.com Direct AGNESIAN HEALTHCARE INC
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other AGNESIAN HEALTHCARE INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070706000443 WI Practitioner - Emergency Medicine 3476653395 Reassigns benefits to 3 organizations
I20170228002070 WA Practitioner - Emergency Medicine 3476653395 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Washington University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puget Sound Physicians PLLCGroup PAC ID 2961301882, 47 clinicians

Practice addresses (Care Compare)

3011 196TH St SW
Lynnwood, WA 98036-6925
Phone (425) 688-5759

Hospital & facility affiliations

  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as group
Quality
95.59
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
78.83
Promoting interoperability
100
Improvement activities
40
Cost
66.97

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01060968AINMDEmergency Medicine Physician
50465-20WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Aug 14, 2023 Accepting new patients
Public Hospital District No 4 King County Washington CurrentSince Feb 6, 2023 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Aug 1, 2018 Accepting new patients
Public Hospital District No 4 King County Washington CurrentSince Feb 6, 2023 Accepting new patients
Reedsburg Area Medical Center Inc CurrentSince Aug 1, 2018 Accepting new patients
Radia Inc P S Past Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients
Stoughton Hospital Association Past Accepting new patients

Locations

619 156th Ave SE
Bellevue, WA 98007
Phone (425) 637-3270

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

10223 NE 10th St
Bellevue, WA 98004
Phone (425) 453-3288

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

5708 E Lake Sammamish Pkwy SE
Ste 102
Issaquah, WA 98029
Phone (425) 688-5488

13159 Newcastle Commons Dr
Newcastle, WA 98059
Phone (425) 635-3010

17209 Redmond Way
Redmond, WA 98052
Phone (425) 635-6400

9801 Frontier Ave SE
Snoqualmie, WA 98065
Phone (425) 831-2300

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

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1750424115",
    "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": "608-826-2710"
        },
        {
            "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": "608-826-2710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-926-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLISTO",
        "first_name": "ANTHONY",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01060968A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "50465-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acallisto269750@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "acallisto269750@direct-ehr-ssmhc.com",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIRAPI",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.