NPIMap

Individual provider Active NPI

Michael D Gordon, MD

  • Orthopaedic Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1659330793
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
46004 Issued in WI
Practice address
1218 W Kilbourn Ave
Suite 301
Milwaukee, WI 53233-1330
Phone
(414) 276-6000
Fax
(414) 276-1758
NPI assigned
Mar 18, 2006
Last updated
Dec 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 46004 WI Primary

Addresses

Primary practice location

1218 W Kilbourn Ave
Suite 301
Milwaukee, WI 53233-1330

Mailing address

1218 W Kilbourn Ave
Suite 301
Milwaukee, WI 53233-1330
Phone (414) 276-6000

Other identifiers 1

IdentifierTypeStateIssuer
34436000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100712000383 WI Practitioner - Orthopedic Surgery 0840322723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Harvard Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milwaukee Orthopaedic Group LTDGroup PAC ID 2769466036, 10 clinicians

Practice addresses (Care Compare)

1218 W Kilbourn Ave
Milwaukee, WI 53233-1330
Phone (414) 276-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.69 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement32
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)19
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46004WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Orthopaedic Group LTD Orthopaedic Surgery CurrentSince Sep 1, 2003 Accepting new patients
Milwaukee Orthopaedic Group LTD PastSince Sep 1, 2003 Accepting new patients
Milwaukee Orthpaedic Group LTD Past Accepting new patients

Locations

10586 N Port Washington Rd
Mequon, WI 53092
Phone (262) 243-9100

1218 W Kilbourn Ave
Milwaukee, WI 53233
Phone (414) 219-7343

1218 W Kilbourn Ave
Ste 301
Milwaukee, WI 53233
Phone (414) 276-6000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1659330793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 W KILBOURN AVE",
            "address_2": "SUITE 301",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331330",
            "telephone_number": "414-276-6000",
            "fax_number": "414-276-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W KILBOURN AVE",
            "address_2": "SUITE 301",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331330",
            "telephone_number": "414-276-6000",
            "fax_number": "414-276-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "46004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34436000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.