Individual provider Active NPI

Michael Thomas Avery, DO

  • Rheumatology Physician
  • Green Bay, WI
National Provider Identifier
1255568069
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
67513 Issued in WI
Practice address
2223 Lime Kiln Rd Ste 1
Green Bay, WI 54311-6213
Phone
(920) 430-8113
NPI assigned
Jun 18, 2009
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 67513 WI Primary

Addresses

Primary practice location

2223 Lime Kiln Rd Ste 1
Green Bay, WI 54311-6213

Mailing address

2223 Lime Kiln Rd Ste 1
Green Bay, WI 54311-6213
Phone (920) 430-8113

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170913000033 WI Practitioner - Rheumatology 0840422200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2223 Lime Kiln Rd
Suite 1
Green Bay, WI 54311-6238
Phone (920) 430-8113

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.2 of 100Reported as individual
Promoting interoperability
92
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67513WIMDRheumatology Physician
935NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Sports Medicine Specialists of Green Bay, SC CurrentSince Jul 31, 2017 Accepting new patients

Locations

2223 Lime Kiln Rd
Ste 1
Green Bay, WI 54311
Phone (920) 468-0246

1931 Marinette Ave
Marinette, WI 54143
Phone (715) 735-5500

1205 West American Dr
Neenah, WI 54956
Phone (920) 727-8144

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0cda6ed7-9e18-4112-ab11-d5a45a40c8d5/
  • Direct secure messaging: michael.avery@osms.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1255568069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD STE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116213",
            "telephone_number": "920-430-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD STE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116213",
            "telephone_number": "920-430-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "67513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.