Organization
SSM HEALTH CARE OF WISCONSIN, INC.
Active
Other names
SSM Health St. Mary's Hospital-Madison
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MINERATH (SYSTEM DIR OF GOV REIMBURSEMENT)
(608) 258-6891
Entity
Organization
Contact information
Practice address
700 S. PARK ST., MADISON, WI 53715-1830
(608) 251-6100
(608) 258-5221
Mailing address
700 S. PARK ST., MADISON, WI 53715-1830
(608) 251-6100
(608) 258-5221
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
—
282N00000X
General Acute Care Hospital
Primary
71
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11022900
—
WI
01
—
390806393
INS PROVIDER NUMBER
WI
01
—
39080639301
UNITY PROVIDER NUMBER
WI
01
—
390806393026
BLUE CROSS PROVIDER NUMBE
WI
01
—
5283846
MEDICA PROVIDER NUMBER
WI
01
—
5389107
PHYSICIANS PLUS PROVIDER
WI
01
—
67
DEANCARE PROVIDER NUMBER
WI
01
—
A5371501
JOHN DEERE PROVIDER NUMBE
WI
Enumeration date
07/05/2005
Last updated
01/21/2025
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