Organization
SSM HEALTH CARE OF WISCONSIN, INC
Active
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) 445-2411
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) 258-6891
(608) 227-0112
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
71
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11022900
WI MEDICAID PROVIDER NUMB
WI
01
—
390806393
OTHER INSURANCE PROVIDER
WI
01
—
39080639301
UNITY PROVIDER NUMBER
WV
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
06/15/2006
Last updated
01/21/2025
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