SSM HEALTH DEAN MEDICAL GROUP - PORTAGE
NPI 1760593545
Durable Medical Equipment & Medical Supplies in Portage, WI
NPI Status: Active since August 31, 2006
Contact Information
2825 HUNTERS TRL
2ND FLOOR
PORTAGE, WI
ZIP 53901
Phone: (608) 742-1063
Fax: (608) 745-3750
- Organization
- Durable Medical Equipment & Medical Supp...
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 52D0393950
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-19-2027
About SSM HEALTH DEAN MEDICAL GROUP - PORTAGE
This page provides the complete NPI Profile along with additional information for Ssm Health Dean Medical Group - Portage, a provider established in Portage, Wisconsin operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1760593545 assigned on August 2006. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Ssm Health Dean Medical Group - Portage. The authorized official of this NPI record is Amy J Grinnell (Vice President - Finance)
- NPI
- 1760593545
- Provider Legal Name
- DEAN HEALTH SYSTEMS, INC
- Other Organization Name
- SSM HEALTH DEAN MEDICAL GROUP - PORTAGE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2825 HUNTERS TRL 2ND FLOOR PORTAGE, WI 53901
- Location Phone
- (608) 742-1063
- Location Fax
- (608) 745-3750
- Mailing Address
- 2825 HUNTERS TRL 2ND FLOOR PORTAGE, WI 53901
- Mailing Phone
- (608) 742-1063
- Mailing Fax
- (608) 745-3750
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-31-2006
- Last Update Date
- 08-03-2020
- Code Navigator
Ssm Health Dean Medical Group - Portage is a medicare supplier with PTAN 20658533 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Heat & Cold Applications or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Walkers or Orthoses: Custom Fabricated or Ostomy Supplies or Tracheotomy Supplies or Urological Supplies or Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses or Prosthetic Lenses: Prosthetics Cataract Lenses or Nebulizer Equipment and/or Supplies or Surgical Dressings or Diabetic Shoes and Inserts or Diabetic Shoes/Inserts - Custom.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Durable Medical Equipment & Medical Supplies
- Taxonomy Code
- 332B00000X
- Type
- Suppliers
- Taxonomy Description
- A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1053358846 | MEDICAID (05) | WI |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20658533
- Accepts Medicare Assignment
- YES
- Specialities List
- Orthotic Personnel, Prosthetic Personnel.
- Provider Type List
- MULTI-SPECIALTY - PHYSICIAN.
- Competitive Bidding
- NO
Supplies List
- Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Infusion Drugs -
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
- Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
- (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies - Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
- Orthoses: Custom Fabricated - Custom met pads, Custom heel pads, Custom heel spur pads
- Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
- Tracheotomy Supplies - Tracheostomy care kits
- Urological Supplies - Catheters, Urinary collection devices
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
- Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
- Diabetic Shoes and Inserts - Shoes, Socks, Insoles
- Diabetic Shoes/Inserts - Custom - Custom fabricated shoes, socks, & insoles
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0393950
- Facility Type
- Physician Office
- Certificate Effective Date
- May 20, 2025
- Certificate Expiration Date
- May 19, 2027
- Laboratory Director
- JEFFREY J. MAXWELL
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Ssm Health Dean Medical Group - Portage after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1760593545, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PORTAGE, WI 53901
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760593545, enumerated as an "organization" on August 31, 2006.
The provider is located at 2825 HUNTERS TRL 2ND FLOOR PORTAGE, WI 53901 and the phone number is (608) 742-1063.
Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
