Hind Mirza Gautam, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

49944 Issued in WI

Practice address

1881 Chicago St
De Pere, WI 54115-3770

Phone

(920) 403-8000

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hind A Mirza Former name

Electronic endpoints 2

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

Specialty

Interventional Pain ManagementAlso: Anesthesiology

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Baycare Medical Ctr Hospital, Green Bay, WI, CCN 520193

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Aurora Medical Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1659599157
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)
• Bone & Joint Clinic S.C.

  • Multi-Specialty Clinic/Center
  • Wausau, WI
  • NPI 1902850696
  NPD (past)

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

• Baycare Aurora, LLC

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1255387726
  Care Compare affiliation

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1316950504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 CHICAGO ST",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541153770",
            "telephone_number": "920-403-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "HIND",
        "middle_name": "MIRZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WI",
            "license": "49944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34748200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hgautam57659@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1881 Chicago St",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541153770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1881 Chicago St",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541153770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HIND",
            "last_name": "MIRZA",
            "middle_name": "A",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Jean Gallistel, D.O.
• Justine Marie Garbaciak, M.S.
• Ashley Gardon, LMFT
• Aleshia Garland, PT
• Sheila Jean Garrigan, LCSW
• Holly Marie Gehri, OTR
• Rebecca Gehrmann, MD
• Allison Ann Gembel, CRNA
• Julie Ann George-Grosskopf, MD
• Corina L Gerczak, PA

• Interventional Pain Medicine Physician in De Pere, WI
• Providers in De Pere, WI by specialty
• Interventional Pain Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.