Utchariya Anantamongkol, MD
Individual provider Active NPI Anesthesiology Physician · Marshfield, WI
NPI 1114346558 · NPPES record last updated Nov 18, 2025
Key facts
- NPI
- 1114346558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- MC-334 (GU)
- Practice address
- 1000 N Oak Ave
Marshfield, WI 54449-5703 - Phone
- (715) 387-5511
- NPI assigned
- Apr 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 12
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Spectrum Health Primary Care Partners
Guam Healthcare Development Incorporated
Associated Anesthesiologists SC
Vituity-Wisconsin Anesthesia SC
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
6742 N Frostwood Pkwy
Peoria, IL 61615-2402
Phone (309) 692-5393
9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8000
9697 Saint Catherines Dr
Pleasant Prairie, WI 53158-2118
Phone (262) 653-5330
Hospital & facility affiliations
- Froedtert South Inc.
- Guam Regional Medical City
- Spectrum Health
- Saint Francis Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.58 of 100
- Quality
- 55.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.46
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in WI, MI, IL, GU
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190822002795 | WI | Practitioner - Anesthesiology | 0446559405 | Reassigns benefits to 3 organizations |
| I20251016002902 | MI | Practitioner - Anesthesiology | 0446559405 | Reassigns benefits to 1 organization |
| I20251106001707 | IL | Practitioner - Anesthesiology | 0446559405 | Reassigns benefits to 1 organization |
| I20251202002983 | GU | Practitioner - Anesthesiology | 0446559405 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC-334 | GU | MD | Anesthesiology Physician |
| 70459-20 | WI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marshfield Clinic Inc | Multi-Specialty | Current |
Accepting new patients |
| Associated Anesthesiologists, S.C. | Multi-Specialty | Current |
Accepting new patients |
| Spectrum Health Primary Care Partners | Multi-Specialty | Current | Accepting new patients |
| Vituity-Wisconsin Anesthesia SC | Multi-Specialty | Current |
Accepting new patients |
| MCHS Hospitals Inc | Multi-Specialty | Current |
Accepting new patients |
| Spectrum Health Primary Care Partners | Multi-Specialty | Current |
Accepting new patients |
| Vituity-Wisconsin Anesthesia SC | Multi-Specialty | Current |
Accepting new patients |
| Guam Healthcare Development Incorporated | Multi-Specialty | Current |
Accepting new patients |
| MCHS Hospitals Inc | Multi-Specialty | Current | Accepting new patients |
| MCHS Hospitals Inc | Current |
Accepting new patients | |
| Associated Anesthesiologists, SC | Anesthesiology | Current |
Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
133 Route 3
Dededo, GU 96929
Phone (671) 645-5500
6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200
1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000
Interoperability endpoints
- him@marshfieldclinichealthsystem.cernerdirect.com
- utchariya.anantamongkol@marshfieldclinichealthsystem.cernerdirect.com
- uanantamongkol827583@direct.froedtert.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | MC-334 | GU | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 70459-20 | WI |
Addresses
Primary practice location
1000 N Oak Ave
Marshfield, WI 54449-5703
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511
Other practice location 1
836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 975-1600
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@marshfieldclinichealthsystem.cernerdirect.com |
Other providers in Marshfield, WI
- Alliance Wellness Center LLC
- Benjamin Lee Alt
- Saba Alvi
- American Homepatient, Inc.
- Liesl Amon
- Bret Andersen
- Niels C Andersen
- Victoria E Andersen
- Dennis R Anderson
- Gregory A Anderson
All providers in Marshfield, WI · Anesthesiology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.