Individual provider Active NPI

Erin Marie Gutowski, D.O., MPH

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1447670963
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
69141 Issued in WI
Practice address
701 Park Ave # P7
Minneapolis, MN 55415
Phone
(612) 873-8562
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 69141 WI Primary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 62005 MN

Addresses

Primary practice location

701 Park Ave # P7
Minneapolis, MN 55415

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other practice location 1

701 Park Ave # P7
Minneapolis, MN 55415-1623
Phone (612) 873-8562

Other practice location 2

701 Park Ave # P7
Minneapolis, MN 55415-1623
Phone (612) 873-8562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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
I20170620002579 MN Practitioner - Pediatric Medicine 7719283936 Reassigns benefits to 2 organizations
I20180810003109 WI Practitioner - Pediatric Medicine 7719283936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62005MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Jun 25, 2017 Accepting new patients
Gundersen Clinic LTD Single Specialty CurrentSince Jul 30, 2018 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jul 30, 2018 Accepting new patients
Fairview Clinics Single Specialty Current Accepting new patients
Fairview Express Care CurrentSince Jun 25, 2017 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Jul 30, 2018 Accepting new patients
Fairview Health Services Single Specialty Current Accepting new patients
Fairview Clinics CurrentSince May 25, 2017 Accepting new patients
Fairview Clinics CurrentSince May 25, 2017 Accepting new patients
Gundersen Lutheran Medical Center Inc Single Specialty CurrentSince Jul 30, 2018 Accepting new patients
Gundersen Lutheran Medical Center Inc Single Specialty Current Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

710 Denton St
La Crosse, WI 54601
Phone (608) 775-6680

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

Interoperability endpoints

  • Direct secure messaging: egutowski230577@direct.emplifyhealth.org

Organizations & group practices 12

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1447670963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE # P7",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-873-8562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave # P7",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-8562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave # P7",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-8562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTOWSKI",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "D.O., MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "69141",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "62005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.