Individual provider Active NPI

Eugene A Gulliver, MD

  • Cardiovascular Disease Physician
  • Janesville, WI
National Provider Identifier
1366401903
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
45190 Issued in WI
Practice address
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone
(608) 756-6868
Fax
(608) 756-6289
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 45190 WI
Cardiovascular Disease Physician 207RC0000X 45190 WI Primary

Addresses

Primary practice location

1000 Mineral Point Ave
Janesville, WI 53548-2940

Mailing address

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6868

Other identifiers 1

IdentifierTypeStateIssuer
GULLIEUGOtherWIMERCYCARE INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060405000250 WI Practitioner - Cardiovascular Disease (Cardiology) 9931117785 Reassigns benefits to 2 organizations
I20200706000869 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9931117785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Medical College of Wisconsin, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

2350 N Rockton Ave
Rockford, IL 61103-3600
Phone (815) 971-2000

Hospital & facility affiliations

  • Mercy Health System Corp Hospital, Janesville, WI, CCN 520066
  • Javon Bea Hospital Hospital, Rockford, IL, CCN 140239
  • Mercy Walworth Hospital & Medical Center Hospital, Lake Geneva, WI, CCN 521357

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting20
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45190WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince May 16, 2020 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 3, 2007 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 3, 2007 Accepting new patients
Mercy Health System Corporation Current Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2350 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-2200

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Interoperability endpoints

  • Direct secure messaging: ggulliver1618@direct.mhemail.org

Organizations & group practices 4

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 3

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1366401903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6868",
            "fax_number": "608-756-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6868",
            "fax_number": "608-756-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLIVER",
        "first_name": "EUGENE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "45190",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "45190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "GULLIEUG",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.