Marley Jo Foertsch, MD
Individual provider Active NPI Internal Medicine Physician · Madison, WI
NPI 1972183044 · NPPES record last updated Sep 30, 2024
Key facts
- NPI
- 1972183044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 8145620 (WI)
- Practice address
- 700 S Park St
Madison, WI 53715-1830 - Phone
- (608) 251-6100
- Fax
- (608) 258-6259
- NPI assigned
- Apr 12, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dean Health Systems Inc
Practice addresses (Care Compare)
700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100
Hospital & facility affiliations
- SSM Health at Home Hospice
- SSM Health St Mary'S Hospital - Madison
- SSM Health St Mary'S Hospital - Janesville
- Columbus Community Hospital
- Upland Hills Health
- SSM Health St Clare Hospital - Baraboo
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241009002538 | WI | Practitioner - Hospitalist | 5698177152 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8145620 | WI | MD | Internal Medicine Physician |
| 81456-20 | WI | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc | Internal Medicine | Current |
Accepting new patients |
| Dean Health Systems, Inc. | Current |
Accepting new patients |
Locations
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325
700 S Park St
Madison, WI 53715
Phone (608) 260-2900
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
Interoperability endpoints
- mfoertsch521107@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 81456-20 | WI | |
| Internal Medicine Physician | 207R00000X | 8145620 | WI | Yes |
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
600 Highland Ave
Madison, WI 53792-1465
Phone (608) 263-6400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972183044 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mfoertsch521107@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Other providers in Madison, WI
- Fm1Afh
- Jude Blessambahe Fobate
- Focus Counseling, Inc
- Sara A. Foelker
- Susan R Foerster
- Chelsea Fogarty
- Claire Fogarty
- Heidi Fogo
- Renee Marie Fohl
- Sharon K Folbrecht
All providers in Madison, WI · Internal Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.