Individual provider Active NPI

Michael Austin Gernant

  • Student in an Organized Health Care Education/Training Program
  • Milwaukee, WI
National Provider Identifier
1285219352
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
507 North 17TH Street
Milwaukee, WI 53233
Phone
(414) 288-0607
NPI assigned
Mar 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

507 North 17TH Street
Milwaukee, WI 53233

Mailing address

507 North 17TH Street
Milwaukee, WI 53233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220214001245 IL Practitioner - Physician Assistant 4082007166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • St Mary Medical Center Hospital, Galesburg, IL, CCN 140064

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jan 6, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

3422 Court St
#A
Pekin, IL 61554
Phone (309) 477-6000

420 NE Glen Oak Ave
Ste 301
Peoria, IL 61603
Phone (309) 655-7668

8600 State Route 91
Peoria, IL 61615
Phone (309) 683-5050

420 NE Glen Oak Ave
Ste 201
Peoria, IL 61603
Phone (309) 655-3800

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

303 N William Kumpf Blvd
Peoria, IL 61605
Phone (309) 676-5546

Organizations & group practices 2

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 1

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": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1285219352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 NORTH 17TH STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 NORTH 17TH STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53233",
            "telephone_number": "414-288-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERNANT",
        "first_name": "MICHAEL",
        "middle_name": "AUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.