Individual provider Active NPI

Michael E Puttkamer, H.I.S

  • Hearing Instrument Specialist
  • Madison, WI
National Provider Identifier
1336483312
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1323-60 Issued in WI
Practice address
4664 E Washington Ave
Madison, WI 53704-3236
Phone
(608) 243-8084
Fax
(608) 249-0157
NPI assigned
Nov 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1323-60 WI Primary

Addresses

Primary practice location

4664 E Washington Ave
Madison, WI 53704-3236

Mailing address

1802 Galloway St
Eau Claire, WI 54703-3467
Phone (715) 831-8966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1323-60WIMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid West Hearing LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1336483312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 GALLOWAY ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033467",
            "telephone_number": "715-831-8966",
            "fax_number": "715-831-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4664 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043236",
            "telephone_number": "608-243-8084",
            "fax_number": "608-249-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTTKAMER",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "H.I.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WI",
            "license": "1323-60",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.