Individual provider Active NPI

Gustavo P Morel, MD

  • Medical Oncology Physician
  • Iron Mountain, MI
National Provider Identifier
1104855030
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
4301077187 Issued in MI
Practice address
1711 S Stephenson Ave Ste 315
Iron Mountain, MI 49801-3650
Phone
(906) 774-6257
Fax
(906) 774-6390
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 4301077187 MI Primary

Addresses

Primary practice location

1711 S Stephenson Ave Ste 315
Iron Mountain, MI 49801-3650

Mailing address

4602 Dept
Carol Stream, IL 60122-4602
Phone (906) 225-4606

Other identifiers 1

IdentifierTypeStateIssuer
4301989MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100820000099 MI Practitioner - Hematology 5395879746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 W Ice Lake Rd
Iron River, MI 49935-9526
Phone (906) 265-0433

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301077187MIMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc Current Accepting new patients
Dickinson County Healthcare System CurrentSince Sep 1, 2014 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients

Locations

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

1711 S Stephenson Ave
Ste 315
Iron Mountain, MI 49801
Phone (906) 774-6257

1400 W Ice Lake Rd
Iron River, MI 49935
Phone (906) 265-6121

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

1414 W Fair Ave
Ste 332
Marquette, MI 49855
Phone (906) 225-3910

510 Ashmun St
Ste 5
Sault South Marie, MI 49783
Phone (906) 632-6013

1010 Olive Ave
Florence, WI 54121
Phone (715) 528-4775

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

Interoperability endpoints

  • Direct secure messaging: gustavo.morel.1@22710.direct.athenahealth.com
  • Direct secure messaging: gustavo.morel@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1104855030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 DEPT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601224602",
            "telephone_number": "906-225-4606",
            "fax_number": "906-225-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 315",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-6257",
            "fax_number": "906-774-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREL",
        "first_name": "GUSTAVO",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MI",
            "license": "4301077187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4301989",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.