Individual provider Active NPI

Teresa A Gonzaga, MD

  • Plastic and Reconstructive Surgery Physician
  • Green Bay, WI
National Provider Identifier
1073776928
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
69135 Issued in WI
Practice address
2605 Development Dr
Green Bay, WI 54311-4240
Phone
(920) 288-8240
Fax
(920) 857-1488
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 69135 WI Primary

Addresses

Primary practice location

2605 Development Dr
Green Bay, WI 54311-4240

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320
Phone (920) 490-9046

Other practice location 1

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-5151

Other practice location 2

245 S Executive Dr Ste 201
Brookfield, WI 53005-4204
Phone (414) 367-9646

Other practice location 3

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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
I20110915000859 MN Practitioner - Neurosurgery 1456522812 Reassigns benefits to 1 organization
I20180828003391 WI Practitioner - Plastic and Reconstructive Surgery 1456522812 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Clinic LLPGroup PAC ID 4385554328, 197 clinicians

Practice addresses (Care Compare)

1500 Arbor Way
Freedom, WI 54130-7305
Phone (920) 490-9046

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.21 of 100Reported as group
Quality
78.54
Promoting interoperability
100
Improvement activities
40
Cost
75.5

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69135WIMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 29, 2018 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 5, 2019 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Feb 16, 2022 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 29, 2018 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Nov 1, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 5, 2019 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Feb 16, 2022 Accepting new patients
Baycare Clinic LLP Neurological Surgery CurrentSince Aug 15, 2023 Accepting new patients
Baycare Clinic LLP CurrentSince Aug 15, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Aug 6, 2018 Accepting new patients
Group Health, Inc. CurrentSince Jul 1, 2011 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

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

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

1035 Kepler Dr
Green Bay, WI 54311

2605 Development Dr
Green Bay, WI 54311
Phone (920) 288-8240

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1500 Arbor Way
Kaukauna, WI 54130
Phone (877) 229-2273

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

2350 N Lake Dr
Ste 400
Milwaukee, WI 53211
Phone (414) 270-1633

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

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

201 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 259-7200

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1073776928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 DEVELOPMENT DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114240",
            "telephone_number": "920-288-8240",
            "fax_number": "920-857-1488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-5151",
            "fax_number": "651-254-3123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "245 S Executive Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530054204",
            "country_code": "US",
            "telephone_number": "414-367-9646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "54701",
            "country_code": "US",
            "telephone_number": "715-858-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZAGA",
        "first_name": "TERESA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WI",
            "license": "69135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.