Individual provider Active NPI

Michal B. Gutowski, MD

  • Ophthalmology Physician
  • Beloit, WI
National Provider Identifier
1730613621
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
75178-20 Issued in WI
Practice address
1905 East Huebbe Parkway
Beloit, WI 53511-1842
Phone
(608) 364-2200
Fax
(608) 265-8060
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 75178 WI
Ophthalmology Physician 207W00000X 75178-20 WI Primary

Addresses

Primary practice location

1905 East Huebbe Parkway
Beloit, WI 53511-1842

Mailing address

1969 West Hart Rd
Beloit, WI 53511-2283
Phone (608) 364-5689

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgutowski1217534@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 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
I20210602001719 WI Practitioner - Ophthalmology 5193076529 Reassigns benefits to 1 organization
I20230214000475 IL Practitioner - Ophthalmology 5193076529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Washington School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, shared by 4 NPIs, 138 clinicians

Practice addresses (Care Compare)

1735 Madison Rd
Beloit, WI 53511-3216
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone (608) 363-5000

5605 E Rockton Rd
Roscoe, IL 61073-7641
Phone (815) 525-4930

Hospital & facility affiliations

  • Beloit Health System Hospital, Beloit, WI, CCN 520100

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
64.82
Promoting interoperability
100
Improvement activities
40
Cost
71.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75178WIMDOphthalmology Physician
75178-20WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System, Inc CurrentSince Jul 20, 2022 Accepting new patients
Beloit Health System, Inc CurrentSince Jul 20, 2022 Accepting new patients
Beloit Clinic, S.C. Ophthalmology Current Accepting new patients
Beloit Health System Inc Ophthalmology Current Accepting new patients
Beloit Health System Inc Ophthalmology CurrentSince Nov 5, 2022 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Beloit Health System, Inc Past Accepting new patients

Locations

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

Interoperability endpoints

  • Direct secure messaging: mgutowski821767@direct.unitypoint.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1730613621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1969 WEST HART RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112283",
            "telephone_number": "608-364-5689",
            "fax_number": "608-364-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 EAST HUEBBE PARKWAY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2200",
            "fax_number": "608-265-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTOWSKI",
        "first_name": "MICHAL",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "75178",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "75178-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgutowski1217534@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "2880 University Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537053644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.