Individual provider Active NPI

Joseph P. Gormley, M.D.

  • Clinical Pathology Physician
  • West Bend, WI
National Provider Identifier
1760547855
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
75347 Issued in WI
Practice address
3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone
(262) 836-7301
Fax
(262) 836-7301
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology Physician 207ZC0006X 75347 WI Primary

Addresses

Primary practice location

3200 Pleasant Valley Rd
West Bend, WI 53095-9274

Mailing address

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7301

Other identifiers 1

IdentifierTypeStateIssuer
100176126MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, 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
I20201203001017 UT Practitioner - Pathology 2365713542 Reassigns benefits to 1 organization
I20220922000677 WI Practitioner - Pathology 2365713542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

2300 Western Ave
Holy Family Memorial
Manitowoc, WI 54220-3712
Phone (920) 320-2011

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

3212 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 334-6165

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

W180 N8065 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

W180N8071 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 253-2700

W180N8085 Town Hall Rd
Suite 301
Menomonee Falls, WI 53051-3518
Phone (262) 257-3200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as group
Quality
90
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75347WIMDClinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Nov 30, 2020 Accepting new patients
University of Utah Adult Services CurrentSince Nov 30, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 15, 2024 Accepting new patients
Black River Health Inc CurrentSince Aug 1, 2022 Accepting new patients
Black River Health Inc Current Accepting new patients
Black River Health Inc CurrentSince Aug 1, 2022 Accepting new patients

Locations

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: jgormley834258@direct.froedtert.com

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 4

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1760547855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-836-7301",
            "fax_number": "262-836-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-836-7301",
            "fax_number": "262-836-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "JOSEPH",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "WI",
            "license": "75347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100176126",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.