NPIMap

Individual provider Active NPI

Andrew Ertl, MD

  • Orthopaedic Surgery Physician
  • Prairie Du Sac, WI
National Provider Identifier
1679894943
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
66056 Issued in WI
Practice address
260 26TH St
Prairie Du Sac, WI 53578-2203
Phone
(608) 643-2471
Fax
(608) 643-4788
NPI assigned
Jun 21, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 66056 WI Primary

Addresses

Primary practice location

260 26TH St
Prairie Du Sac, WI 53578-2203

Mailing address

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-2471

Other practice location 1

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

Other identifiers 2

IdentifierTypeStateIssuer
000495OtherPTAN
100058595MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aertl@OASP1875.srs-direct.com

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
I20160914000049 WI Practitioner - Orthopedic Surgery 2668625617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Wisconsin, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sauk Prairie Healthcare IncGroup PAC ID 8224948054, 122 clinicians

Practice addresses (Care Compare)

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-3311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement67
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sauk Prairie Healthcare, Inc. CurrentSince Aug 15, 2016 Accepting new patients
Sauk Prairie Healthcare Inc Orthopaedic Surgery CurrentSince Aug 15, 2016 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients

Locations

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

Interoperability endpoints

  • Direct secure messaging: aertl@oasp1875.srs-direct.com
  • Direct secure messaging: andrew.ertl@direct.saukprairiehealthcare.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, 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": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679894943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782203",
            "telephone_number": "608-643-2471",
            "fax_number": "608-643-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782203",
            "telephone_number": "608-643-2471",
            "fax_number": "608-643-4788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Leffingwell Ave NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495256406",
            "country_code": "US",
            "telephone_number": "616-459-7101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERTL",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "66056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "000495",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100058595",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aertl@OASP1875.srs-direct.com",
            "affiliation": "N",
            "address_1": "260 26th St",
            "city": "Prairie Du Sac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535782203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prairie Du Sac, WI

Sources for this page

Verify at the official NPI Registry.