Michelle Mortensen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3989-23 Issued in WI

Practice address

2844 Index Rd
Fitchburg, WI 53713-3117

Phone

(608) 229-7979

Fax

(608) 229-8110

NPI assigned

Sep 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upland Hills Health Hospital, Dodgeville, WI, CCN 521352
• SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
• Stoughton Hospital Hospital, Stoughton, WI, CCN 521343

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmortensen345591@direct-ehr-ssmhc.com

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.

• Dean Health Systems, Inc

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Dean Health Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

• SSM Health Care of Wisconsin, Inc.

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  Care Compare affiliation
• Stoughton Hospital Association

  • Urgent Care Clinic/Center
  • McFarland, WI
  • NPI 1477146082

  Hospital

  Care Compare affiliation
• Stoughton Hospital Association

  • Critical Access Hospital
  • Stoughton, WI
  • NPI 1679558647
  Care Compare affiliation
• Stoughton Hospital Association

  • Urgent Care Clinic/Center
  • Cottage Grove, WI
  • NPI 1811733066

  Hospital

  Care Compare affiliation
• Upland Hills Health Inc

  • Surgery Physician
  • Dodgeville, WI
  • NPI 1821258740

  Hospital

  Care Compare affiliation
• Upland Hills Health, Inc

  • Community Based Hospice Care Agency
  • Dodgeville, WI
  • NPI 1659472397

  Hospital

  Care Compare affiliation
• Upland Hills Health, Inc

  • Family Medicine Physician
  • Highland, WI
  • NPI 1801971734

  Hospital

  Care Compare affiliation
• Upland Hills Health, Inc.

  • Family Medicine Physician
  • Highland, WI
  • NPI 1083958698

  Hospital

  Care Compare affiliation
• Upland Hills Health, Inc.

  • Family Medicine Physician
  • Montfort, WI
  • NPI 1356685960

  Hospital

  Care Compare affiliation
• Upland Hills Health, Inc.

  • Critical Access Hospital
  • Dodgeville, WI
  • NPI 1487745501
  Care Compare affiliation

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1972052371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 W BELTLINE HWY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132334",
            "telephone_number": "608-250-1497",
            "fax_number": "608-250-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 INDEX RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537133117",
            "telephone_number": "608-229-7979",
            "fax_number": "608-229-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109846",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3989-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972052371",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmortensen345591@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mmortensen345591@direct-ehr-ssmhc.com",
            "address_1": "2844 Index Rd",
            "city": "Fitchburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537133117",
            "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": "2844 Index Rd",
            "city": "Fitchburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537133117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cassandra Montanio
• Erin Nicole Moon, LCSW
• Andrew D Moore, MD
• Cynthia R Moore, APSW
• Mary Patricia Moran, M.S.
• Haley Noel Moshier, OTR/L
• Caitlin G. Mosman Block
• Golshan Motamedi, MS LMFT
• Shalla Moy
• Christopher K Mukora

• Physician Assistant in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.