NPIMap

Dean Health Systems, Inc

Organization Active NPI Durable Medical Equipment & Medical Supplies · Portage, WI

NPI 1760593545 · NPPES record last updated Aug 3, 2020

Key facts

NPI
1760593545
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
DEAN HEALTH SYSTEMS, INC
Practice address
2825 Hunters TRL
2ND Floor
Portage, WI 53901
Phone
(608) 742-1063
Fax
(608) 745-3750
NPI assigned
Aug 31, 2006
Organization subpart
No

Authorized official

Name
Amy J Grinnell
Title
Vice President - Finance
Phone
(608) 260-3586

Other NPIs with the same Medicare PAC ID 20

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

Corporate family (same tax ID) 26

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

View all 26

Practitioners 1,174

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,174

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0393950SSM Health Dean Medical Group -Portage
2825 Hunters Trail, Portage, WI 53901		ComplianceMay 19, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930061993 WI DME Supplier - Multi-Specialty - Physician 7012827983 Practice locations: Portage, WI

National Provider Directory

Tax ID family
Dean Medical Ctr - Beav (27 organizations share this tax ID)

Locations

2825 Hunters Trl
Fl 2ND
Portage, WI 53901
Phone (608) 742-1063

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

2825 Hunters TRL
2ND Floor
Portage, WI 53901

Mailing address

2825 Hunters TRL
2ND Floor
Portage, WI 53901-3429
Phone (608) 742-1063

Other identifiers

IdentifierTypeStateIssuer
1053358846MedicaidWI

Other names

  • SSM Health Dean Medical Group - Portage Doing business as

Other providers in Portage, WI

All providers in Portage, WI · Durable Medical Equipment & Medical Supplies in Wisconsin

Sources for this page

Verify at the official NPI Registry.