Individual provider Active NPI

Tyler Boschuetz, MD

  • Obstetrics & Gynecology Physician
  • Janesville, WI
National Provider Identifier
1063809416
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
70583 Issued in WI
Practice address
3200 E Racine St
Janesville, WI 53546-2343
Phone
(608) 371-8000
Fax
(608) 371-8927
NPI assigned
Apr 23, 2015
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 70583 WI Primary

Addresses

Primary practice location

3200 E Racine St
Janesville, WI 53546-2343

Mailing address

3200 E Racine St
Janesville, WI 53546-2343
Phone (608) 371-8000

Other practice location 1

231 Albert Sabin Way
Cincinnati, OH 45267-2827
Phone (513) 584-8239

Other practice location 2

19475 W North Ave Ste 400
Brookfield, WI 53045-4199
Phone (262) 780-4000

Other identifiers 1

IdentifierTypeStateIssuer
1063809416MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address tboschuetz482058@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606002320 WI Practitioner - Obstetrics/Gynecology 8729391040 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Wisconsin, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Melius, Schurr and CardwellGroup PAC ID 2062479280, 8 clinicians

Practice addresses (Care Compare)

2955 Triverton Pike Rd
Fitchburg, WI 53711-5807
Phone (608) 227-7007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
70583WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Jul 25, 2023 Accepting new patients
The Monroe Clinic, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jul 25, 2023 Accepting new patients
Melius, Schurr & Cardwell Obstetrics & Gynecology CurrentSince Oct 1, 2024 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Obstetrics & Gynecology CurrentSince Jun 3, 2019 Accepting new patients
The Monroe Clinic, Inc. CurrentSince Nov 1, 2023 Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

19475 W North Ave
Ste 305
Brookfield, WI 53045
Phone (262) 780-4070

2955 Triverton Pike Dr
Fitchburg, WI 53711
Phone (608) 227-7007

3200 E Racine St
Janesville, WI 53546
Phone (608) 371-8000

2009 5th St
Monroe, WI 53566
Phone (608) 324-1454

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1063809416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462343",
            "telephone_number": "608-371-8000",
            "fax_number": "608-371-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462343",
            "telephone_number": "608-371-8000",
            "fax_number": "608-371-8927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 Albert Sabin Way",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452672827",
            "country_code": "US",
            "telephone_number": "513-584-8239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19475 W North Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530454199",
            "country_code": "US",
            "telephone_number": "262-780-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSCHUETZ",
        "first_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "70583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063809416",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3200 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tboschuetz482058@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tboschuetz482058@direct-ehr-ssmhc.com",
            "address_1": "3200 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.