Active NPI
Michael Gutzeit, M.D.
- Pediatrics Physician
- New Berlin, WI
National Provider Identifier
1104813328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 27646
- Practice address
- 4855 S Moorland Rd Ste 250
New Berlin, WI 53151-7494 - Phone
- (262) 789-6020
- Fax
- (262) 789-6025
- NPI assigned
- Oct 3, 2005
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 27646 | WI | Primary |
Addresses
Primary practice location
4855 S Moorland Rd Ste 250
New Berlin, WI 53151-7494
Mailing address
3610 Michelle Witmer Memorial Dr
Suite 100
New Berlin, WI 53151-5292
Phone (262) 789-6020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27646 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Medical Group | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- mgutzeit7834@direct.chw.org
Organizations & group practices 1
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": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1104813328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3610 MICHELLE WITMER MEMORIAL DR",
"address_2": "SUITE 100",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531515292",
"telephone_number": "262-789-6020",
"fax_number": "262-789-6025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 S MOORLAND RD STE 250",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531517494",
"telephone_number": "262-789-6020",
"fax_number": "262-789-6025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTZEIT",
"first_name": "MICHAEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-03",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "27646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.