Michael A Puglisi, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3428-23 Issued in WI

Practice address

225 Memorial Dr Ste 1100
Berlin, WI 54923-1243

Phone

(920) 361-5535

Fax

(920) 361-6337

NPI assigned

Jul 8, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thedacare Medical Center - Berlin Inc Hospital, Berlin, WI, CCN 521355
• Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpuglisi183906@direct.thedacare.org

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.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment Care Compare group NPD
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  NPD (past)

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

• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Ripon, WI
  • NPI 1326493602
  Care Compare affiliation
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  Care Compare affiliation
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Wautoma, WI
  • NPI 1992159289
  Care Compare affiliation
• Thedacare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Neenah, WI
  • NPI 1023472842
  Care Compare affiliation
• Thedacare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Menasha, WI
  • NPI 1720434806
  Care Compare affiliation
• Thedacare Regional Medical Center-Neenah, Inc.

  • General Acute Care Hospital
  • Neenah, WI
  • NPI 1518993880
  Care Compare affiliation
• Thedacare Regional Medical Center-Neenah, Inc.

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1861943409
  Care Compare affiliation
• Thedcare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1679937494
  Care Compare affiliation

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1376984229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115794",
            "telephone_number": "920-996-3264",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEMORIAL DR STE 1100",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231243",
            "telephone_number": "920-361-5535",
            "fax_number": "920-361-6337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "752 N High Point Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537172236",
            "country_code": "US",
            "telephone_number": "608-824-4000",
            "fax_number": "608-824-4910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGLISI",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3428-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen J Nickelatti, APNP
• Northeast Wisconsin Foot and Ankle Assoc., S.C.
• David P. Parker, PT
• Ruchita Jayeshkumar Patel, PHARMD
• Abigail K Puglisi, DO
• Mary Ellen F Pumper, RPH
• Anthony J. Racki, MD
• Emily Anne Rademacher, COTA
• Vicki Christine Ray, DNP APNP
• Ty Rebedew

• Physician Assistant in Berlin, WI
• Providers in Berlin, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.