George T Poullette, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30486 Issued in WI

Practice address

10256 Old Green Bay Road
Pleasant Prairie, WI 53158-2815

Phone

(262) 551-4200

Fax

(262) 551-4947

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

University of Wisconsin School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Preceptor Home Health South Home health agency, Kenosha, WI, CCN 527024
• Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
• Centerwell Home Health Home health agency, West Allis, WI, CCN 527207
• Horizon Home Care and Hospice Home health agency, Milwaukee, WI, CCN 527083
• Hospice Alliance Hospice, Pleasant Prairie, WI, CCN 521502
• Horizon Homecare and Hospice Hospice, Milwaukee, WI, CCN 521531
• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021
• Brookside Care Center Nursing home, Kenosha, WI, CCN 525556

Merit-based Incentive Payment System (MIPS)

Final score

83.15 of 100Reported as group

Quality

69.39

Promoting interoperability

100

Improvement activities

40

Cost

74.44

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gpoullette342095@direct.froedtert.com

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.

• Froedtert South, Inc.

  • Family Medicine Physician
  • Kenosha, WI
  • NPI 1558305284
  Medicare reassignment Care Compare group NPD
• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  NPD (past)

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

• Brookside Care Center

  • Skilled Nursing Facility
  • Kenosha, WI
  • NPI 1558329185

  Nursing home

  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • West Allis, WI
  • NPI 1225064926
  Care Compare affiliation
• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  Care Compare affiliation
• Horizon Home Care & Hospice, Inc.

  • Home Health Agency
  • Milwaukee, WI
  • NPI 1780687327
  Care Compare affiliation
• Hospice Alliance, Inc.

  • Community Based Hospice Care Agency
  • Pleasant Prairie, WI
  • NPI 1053314252
  Care Compare affiliation
• Southport Healthcare LLC

  • Home Health Agency
  • Kenosha, WI
  • NPI 1285352500
  Care Compare affiliation
• Visiting Nurse Association of Wisconsin, Inc.

  • Home Health Agency
  • West Allis, WI
  • NPI 1134255037
  Care Compare affiliation

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104933415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-577-8320",
            "fax_number": "262-577-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10256 OLD GREEN BAY ROAD",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582815",
            "telephone_number": "262-551-4200",
            "fax_number": "262-551-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULLETTE",
        "first_name": "GEORGE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "30486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI LICENSE",
            "identifier": "30486-20",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dwayne Pinon
• Jill Plaisted
• Pleasant Prairie Eyecare, Inc
• Polykarpos Anesthesia LLC
• Kevin Roy Poole, PA-C
• Michael Alan Price, MD
• Reeba Annie Prince, M.D.
• Professional Home Care Providers
• Quirt Family Dentistry, SC
• Sumithra Rajendran

• Family Medicine Physician in Pleasant Prairie, WI
• Providers in Pleasant Prairie, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.