NPIMap

Individual provider Active NPI

Geffrey E Cavallin, MD

  • Hospitalist Physician
  • Green Bay, WI
National Provider Identifier
1225061625
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
42743 Issued in WI
Practice address
835 S Van Buren St
Green Bay, WI 54301-3526
Phone
(920) 496-4700
Fax
(920) 431-3267
NPI assigned
Jul 8, 2006
Last updated
Mar 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 42743 WI Primary

Addresses

Primary practice location

835 S Van Buren St
Green Bay, WI 54301-3526

Mailing address

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Other identifiers 1

IdentifierTypeStateIssuer
34031700MedicaidWI

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
I20040223000161 WI Practitioner - Internal Medicine 8325934920 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Hospital-Hospital Sisters-Third Order of St FrancisGroup PAC ID 5799694675, shared by 16 NPIs, 593 clinicians

Practice addresses (Care Compare)

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42743WIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Oct 31, 2000 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Hospitalist CurrentSince Aug 1, 2009 Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince Mar 1, 2019 Accepting new patients
St. Mary's Hospital Medical Center of Green Bay Inc.-Hospital Sisters CurrentSince Jul 8, 2006 Accepting new patients
St Mary's Hospital Medical Center of Green Bay Inc.-Hospital Sisters CurrentSince Jul 8, 2006 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Oct 31, 2000 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Mar 1, 2019 Accepting new patients

Locations

1715 Dousman St
Green Bay, WI 54303

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

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

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1225061625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-496-4700",
            "fax_number": "920-431-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-496-4700",
            "fax_number": "920-431-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLIN",
        "first_name": "GEFFREY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "42743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34031700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.