Individual provider Active NPI

Michelle Louise Gauthier, DO

  • Family Medicine Physician
  • Pleasant Prairie, WI
National Provider Identifier
1265489264
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39272 Issued in WI
Practice address
9697 Saint Catherines Dr
Pleasant Prairie, WI 53158-2118
Phone
(262) 577-8320
Fax
(262) 577-8372
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39272 WI Primary

Addresses

Primary practice location

9697 Saint Catherines Dr
Pleasant Prairie, WI 53158-2118

Mailing address

9697 Saint Catherines Dr
Pleasant Prairie, WI 53158-2118
Phone (262) 577-8320

Other identifiers 2

IdentifierTypeStateIssuer
43499900MedicaidWI
081091455OtherWIMEDICARE RR

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
I20101022001266 WI Practitioner - Family Practice 7719170661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians
Vituity-Wisconsin HM SCGroup PAC ID 4880056126, 29 clinicians
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

10222 74TH St
Suite 211
Kenosha, WI 53142-6810
Phone (262) 925-5020

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8000

Hospital & facility affiliations

  • Preceptor Home Health South Home health agency, Kenosha, WI, CCN 527024
  • Centerwell Home Health Home health agency, West Allis, WI, CCN 527207
  • Horizon Home Care and Hospice Home health agency, Milwaukee, WI, CCN 527083
  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Ascension at Home Home health agency, Milwaukee, WI, CCN 527187
  • Hospice Alliance Hospice, Pleasant Prairie, WI, CCN 521502
  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021
  • Brookside Care Center Nursing home, Kenosha, WI, CCN 525556
  • Complete Care at Grande Prairie Nursing home, Pleasant Prairie, WI, CCN 525659

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39272WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. Family Medicine CurrentSince Aug 12, 2002 Accepting new patients
Vituity-Wisconsin HM SC CurrentSince Dec 10, 2023 Accepting new patients
Froedtert South, Inc. Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

9697 Saint Catherines Dr
Pleasant Prairie, WI 53158
Phone (262) 577-8141

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

9697 Saint Catherines Dr
Ste 300
Pleasant Prairie, WI 53158
Phone (262) 577-8320

Interoperability endpoints

  • Direct secure messaging: mgauthier339100@direct.froedtert.com

Organizations & group practices 3

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 9

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1265489264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9697 SAINT CATHERINES DR",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582118",
            "telephone_number": "262-577-8320",
            "fax_number": "262-577-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9697 SAINT CATHERINES DR",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582118",
            "telephone_number": "262-577-8320",
            "fax_number": "262-577-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "MICHELLE",
        "middle_name": "LOUISE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "39272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43499900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "081091455",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.