Individual provider Active NPI

Gregory M Cavanaugh, PA-C

  • Physician Assistant
  • Greenfield, WI
National Provider Identifier
1124084462
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1261023 Issued in WI
Practice address
4131 W. Loomis Rd.
Ste 300
Greenfield, WI 53221-2059
Phone
(414) 325-7246
Fax
(414) 325-3770
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1261023 WI Primary

Addresses

Primary practice location

4131 W. Loomis Rd.
Ste 300
Greenfield, WI 53221-2059

Mailing address

4131 W. Loomis Rd.
Ste 300
Greenfield, WI 53221-2059
Phone (414) 325-7246

Other identifiers 1

IdentifierTypeStateIssuer
30118100MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/Documentsubmission/2_0/Nhinservice/XDRRequest_Service Other Ability Network
Direct Messaging Address gcavanaugh24915@direct.myadvocateaurora.org 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607000418 WI Practitioner - Physician Assistant 4688656234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Beginnings, LLCGroup PAC ID 7012189848, 19 clinicians
Pain Physicians of Wisconsin SCGroup PAC ID 9537596341, 28 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1125 N 13TH St
Sheboygan, WI 53081-3281
Phone (920) 803-1617

1200 Delafield St
Waukesha, WI 53188-3430
Phone (262) 297-7246

2500 W Layton Ave
Suite 200
Milwaukee, WI 53221-5434
Phone (262) 297-7246

3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 828-2530

Hospital & facility affiliations

  • Aurora Medical Center Sheboygan County Hospital, Sheboygan, WI, CCN 520035

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
59.26
Promoting interoperability
98
Improvement activities
40
Cost
72.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1261023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Franklin Cardiac Center LLC Past Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Physician Assistant Past Accepting new patients
Madison Surgicenter LLC Past Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

4202 W Oakwood Park Ct
Ste 110
Franklin, WI 53132
Phone 26229772461310

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

6308 8th Ave
Ste 402
Kenosha, WI 53143
Phone (414) 656-8271

10105 74th St
Ste 101
Kenosha, WI 53142
Phone (262) 697-5056

4131 W Loomis Rd
Ste 300
Milwaukee, WI 53221
Phone (414) 325-3713

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3400 Union Ave
Sheboygan, WI 53081
Phone (920) 802-2100

725 American Ave
#5
Waukesha, WI 53188
Phone (262) 928-2475

725 American Ave
Ste 5
Waukesha, WI 53188
Phone (262) 544-2384

Organizations & group practices 8

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 2

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1124084462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W. LOOMIS RD.",
            "address_2": "STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212059",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 W. LOOMIS RD.",
            "address_2": "STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212059",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "GREGORY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1261023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30118100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/Documentsubmission/2_0/Nhinservice/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gcavanaugh24915@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3400 Union Ave",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530818426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.