Individual provider Active NPI

Merritt Tuttle

  • Pediatrics Physician
  • Milwaukee, WI
National Provider Identifier
1073044566
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
69951 Issued in WI
Practice address
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone
(414) 266-2000
Fax
(414) 337-7068
NPI assigned
Mar 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 69951 WI
Pediatrics Physician 208000000X 69951 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-2000

Other identifiers 1

IdentifierTypeStateIssuer
1073044566MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230810003871 WI Practitioner - Pediatric Medicine 7810237278 Reassigns benefits to 1 organization
I20260221000390 NC Practitioner - Pediatric Medicine 7810237278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Saint Louis University School of Medicine, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Kimel Forest Dr
Winston Salem, NC 27103-6074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69951WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jan 14, 2026 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Aug 26, 2023 Accepting new patients
Medical College of Wisconsin Affiliated Hospitals Student in an Organized Health Care Education/Training Program Past Accepting new patients

Locations

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: mtuttle55335@direct.chw.org
  • Direct secure messaging: mtuttle3025001@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1073044566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-2000",
            "fax_number": "414-337-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-2000",
            "fax_number": "414-337-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "MERRITT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-25",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WI",
            "license": "69951",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "69951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073044566",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.