Individual provider Active NPI

Cheryl R Goeckermann, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Baraboo, WI
National Provider Identifier
1083670665
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
38184-20 Issued in WI
Practice address
1700 Tuttle St
Baraboo, WI 53913-3319
Phone
(608) 355-3800
Fax
(608) 355-7001
NPI assigned
Apr 24, 2006
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38184-020 WI
Addiction Medicine (Internal Medicine) Physician 207RA0401X 38184-20 WI Primary

Addresses

Primary practice location

1700 Tuttle St
Baraboo, WI 53913-3319

Mailing address

1700 Tuttle St
Baraboo, WI 53913-3319
Phone (608) 355-3800

Other identifiers 1

IdentifierTypeStateIssuer
1083670665MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address cgoeckermann262513@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
I20051222000571 WI Practitioner - Addiction MedicinePractitioner - Family Practice 6305868969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction MedicineAlso: Family Practice
Education
Medical College of Wisconsin, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38184-020WIMDFamily Medicine Physician
38184-20WIMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Family Medicine CurrentSince Nov 1, 2014 Accepting new patients
Dean Health Systems, Inc. CurrentSince Nov 1, 2014 Accepting new patients
St. Marys Dean Ventures Inc. Current Accepting new patients
Dean Health Systems, Inc, Past Accepting new patients

Locations

1700 Tuttle St
Baraboo, WI 53913
Phone (608) 355-3800

825 Western Ave
Columbus, WI 53925
Phone (920) 623-2520

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

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

237 W Seward St
Poynette, WI 53955
Phone (608) 635-4343

Interoperability endpoints

  • Direct secure messaging: cgoeckermann262513@direct-ehr-ssmhc.com

Organizations & group practices 4

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.

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": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1083670665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TUTTLE ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539133319",
            "telephone_number": "608-355-3800",
            "fax_number": "608-355-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TUTTLE ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539133319",
            "telephone_number": "608-355-3800",
            "fax_number": "608-355-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOECKERMANN",
        "first_name": "CHERYL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-24",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "38184-020",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "WI",
            "license": "38184-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083670665",
            "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": "1700 Tuttle St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539133319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgoeckermann262513@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cgoeckermann262513@direct-ehr-ssmhc.com",
            "address_1": "1700 Tuttle St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539133319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.