Provider Demographics
| NPI: | 1053358846 |
|---|---|
| Name: | DEAN HEALTH SYSTEMS, INC |
| Entity type: | Organization |
| Organization Name: | DEAN HEALTH SYSTEMS, INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | VICE PRESIDENT-FINANCE |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | AMY |
| Authorized Official - Middle Name: | J |
| Authorized Official - Last Name: | GRINNELL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 608-260-3586 |
| Mailing Address - Street 1: | 1808 W BELTLINE HWY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MADISON |
| Mailing Address - State: | WI |
| Mailing Address - Zip Code: | 53713-2334 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 608-252-8000 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1211 FISH HATCHERY RD |
| Practice Address - Street 2: | |
| Practice Address - City: | MADISON |
| Practice Address - State: | WI |
| Practice Address - Zip Code: | 53715-1909 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 608-252-8000 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-01 |
| Last Update Date: | 2023-05-24 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
| No | 208C00000X | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | Group - Multi-Specialty | |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| WI | 38722200 | Medicaid | |
| WI | 41174000 | Medicaid | |
| WI | 41809500 | Medicaid | |
| WI | 42134400 | Medicaid | |
| WI | 44012400 | Medicaid | |
| WI | 41624000 | Medicaid | |
| WI | 32743800 | Medicaid | |
| WI | 43410400 | Medicaid | |
| WI | 38722200 | Medicaid | |
| WI | 41174000 | Medicaid | |
| WI | 526776 | Medicare Oscar/Certification | |
| WI | 41809500 | Medicaid | |
| WI | 000057085 | Medicare PIN | |
| WI | 000054340 | Medicare PIN |
