Individual provider Active NPI

Paul C Utrie, MD

  • Rheumatology Physician
  • Green Bay, WI
National Provider Identifier
1326065368
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
38895 Issued in WI
Practice address
2223 Lime Kiln Rd
Suite 1
Green Bay, WI 54311-6213
Phone
(920) 430-8120
Fax
(920) 430-8122
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 38895 WI Primary

Addresses

Primary practice location

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

Mailing address

2223 Lime Kiln Rd
Suite 1
Green Bay, WI 54311-6213
Phone (920) 430-8120

Other identifiers 1

IdentifierTypeStateIssuer
32336700MedicaidWI

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
I20040424000035 WI Practitioner - RheumatologyPractitioner - Internal Medicine 1355337296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
University of Wisconsin School of Medicine, 1992
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
88.95 of 100Reported as individual
Promoting interoperability
87
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Sports Medicine Specialists of Green Bay, SC CurrentSince Jul 6, 2009 Accepting new patients

Locations

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

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

Interoperability endpoints

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

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1326065368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD",
            "address_2": "SUITE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116213",
            "telephone_number": "920-430-8120",
            "fax_number": "920-430-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD",
            "address_2": "SUITE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116213",
            "telephone_number": "920-430-8120",
            "fax_number": "920-430-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTRIE",
        "first_name": "PAUL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "38895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32336700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.