NPIMap

Individual provider Active NPI

Justin Gabriel Hartke, M.D.

  • Gastroenterology Physician
  • Wausau, WI
National Provider Identifier
1154689685
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
69359-20 Issued in WI
Practice address
411 Westwood Dr
Wausau, WI 54401
Phone
(715) 847-2558
Fax
(715) 847-2557
NPI assigned
May 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 69359-20 WI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

411 Westwood Dr
Wausau, WI 54401

Mailing address

411 Westwood Dr
Wausau, WI 54401-4152
Phone (715) 847-2558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180820001506 WI Practitioner - Gastroenterology 6002043965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Wright State University Boonshoft School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastrointestinal Associates S.C.Group PAC ID 4385677814, 42 clinicians

Practice addresses (Care Compare)

411 Westwood Dr
Wausau, WI 54401-4152
Phone (715) 847-2558

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.86 of 100Reported as group
Quality
86.95
Promoting interoperability
100

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.16
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy111
Upper gastrointestinal (GI) endoscopy for acid reflux104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69359-20WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Associates S.C. Gastroenterology CurrentSince Aug 1, 2018 Accepting new patients

Locations

3225 Business Park Dr
Stevens Point, WI 54482
Phone (715) 847-2558

411 Westwood Dr
Wausau, WI 54401
Phone (715) 479-0374

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

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 and National Provider Directory roles.

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1154689685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WESTWOOD DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014152",
            "telephone_number": "715-847-2558",
            "fax_number": "715-847-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WESTWOOD DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-847-2558",
            "fax_number": "715-847-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTKE",
        "first_name": "JUSTIN",
        "middle_name": "GABRIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "69359-20",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.