Individual provider Active NPI

Stefanie L Haima, PT

  • Physical Therapist
  • Madison, WI
National Provider Identifier
1912219122
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4901 Cottage Grove Rd
Madison, WI 53716-1392
Phone
(608) 221-1501
NPI assigned
Jul 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

4901 Cottage Grove Rd
Madison, WI 53716-1392

Mailing address

4901 Cottage Grove Rd
Madison, WI 53716-1392
Phone (608) 221-1501

Other identifiers 1

IdentifierTypeStateIssuer
P00865623OtherILMEDICARE RR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address shaima260201@direct-ehr-ssmhc.com Direct
FHIR URL https//fhir.ssmhc.com/fhir/api/FHIR/DSTU2 Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161114002469 WI Practitioner - Physical Therapist in Private Practice 8325231814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wildwood Family Clinic SCGroup PAC ID 9537137484, 27 clinicians

Practice addresses (Care Compare)

4901 Cottage Grove Rd
Madison, WI 53716-1392
Phone (608) 221-1501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1912219122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 COTTAGE GROVE RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161392",
            "telephone_number": "608-221-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 COTTAGE GROVE RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161392",
            "telephone_number": "608-221-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIMA",
        "first_name": "STEFANIE",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-06",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00865623",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shaima260201@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "shaima260201@direct-ehr-ssmhc.com",
            "address_1": "4901 Cottage Grove Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537161392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https//fhir.ssmhc.com/fhir/api/FHIR/DSTU2",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4901 Cottage Grove Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537161392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.