Individual provider Active NPI

Michael Goshorn

  • Family Medicine Physician
  • West Allis, WI
National Provider Identifier
1750737367
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71165 Issued in WI
Practice address
6609 W Greenfield Ave
West Allis, WI 53214-4958
Phone
(414) 257-8500
Fax
(414) 257-8505
NPI assigned
May 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125-068084 IL
Family Medicine Physician 207Q00000X 71165 WI Primary

Addresses

Primary practice location

6609 W Greenfield Ave
West Allis, WI 53214-4958

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
100089112MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mgoshorn229821@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190621001660 WI Practitioner - Family Practice 3375813900 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2424 S 90TH St
West Allis, WI 53227-2455
Phone (414) 328-8630

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-068084ILMDFamily Medicine Physician
71165WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. Family Medicine CurrentSince Jul 15, 2019 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jul 15, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 15, 2019 Accepting new patients
Lakeshore Medical Clinic, LLC Family Medicine CurrentSince Jul 15, 2019 Accepting new patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Jul 15, 2019 Accepting new patients
Lakeshore Medical Clinic LTD Family Medicine CurrentSince Jul 15, 2019 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

14555 W National Ave
Ste 160
New Berlin, WI 53151
Phone (262) 827-2975

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

6609 W Greenfield Ave
West Allis, WI 53214
Phone (414) 257-8500

2424 S 90th St
West Allis, WI 53227
Phone (414) 321-2255

Interoperability endpoints

  • Direct secure messaging: mgoshorn229821@direct.myadvocateaurora.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 5

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1750737367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144958",
            "telephone_number": "414-257-8500",
            "fax_number": "414-257-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSHORN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125-068084",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "71165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089112",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgoshorn229821@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2424 S 90th St",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2424 S 90th St",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.