Cathy Fakler Azzarello, M.D.

Individual provider Active NPI Pediatrics Physician · Hancock, MI

NPI 1427166313 · NPPES record last updated May 13, 2026

Key facts

NPI
1427166313
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
4301111513 (MI)
Practice address
500 Campus Dr
Hancock, MI 49930-1452
Phone
(906) 483-1700
Fax
(906) 372-3230
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160104002255 WI Practitioner - Pediatric Medicine 8729380050 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301111513MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Current
since Jan 1, 2016
Accepting new patients
Portage Hospital LLC Past Accepting new patients
Upper Great Lakes Family Health Center Past Accepting new patients
Upper Great Lakes Family Health Center Past Accepting new patients
Upper Great Lakes Family Health Center Past Accepting new patients

Locations

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: cathy.azzarello@uglfhc.eclinicaldirectplus.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301111513 MI Yes

Addresses

Primary practice location

500 Campus Dr
Hancock, MI 49930-1452

Mailing address

135 E M35
Gwinn, MI 49841-9160
Phone (906) 346-4924

Other identifiers

IdentifierTypeStateIssuer
1427166313MedicaidMI

Other names

  • Cathy R Fakler Former name

Other providers in Hancock, MI

All providers in Hancock, MI · Pediatrics Physician in Michigan

Sources for this page

Verify at the official NPI Registry.