Michael K Augustson, MD
Individual provider Active NPI Family Medicine Physician · Beaver Dam, WI
NPI 1770534208 · NPPES record last updated Feb 8, 2017
Key facts
- NPI
- 1770534208
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 27426-020 (WI)
- Practice address
- 705 S University Ave
Ste 510
Beaver Dam, WI 53916-3081 - Phone
- (920) 885-8586
- Fax
- (920) 885-8771
- NPI assigned
- May 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051228000292 | WI | Practitioner - Family Practice | 7113949645 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27426-020 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients |
Locations
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 27426-020 | WI | Yes |
Addresses
Primary practice location
705 S University Ave
Ste 510
Beaver Dam, WI 53916-3081
Mailing address
705 S University Ave
Ste 510
Beaver Dam, WI 53916-3081
Phone (920) 885-8586
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770534208 | Medicaid | WI |
Other providers in Beaver Dam, WI
- Samantha Alvarado
- Ameripath Milwaukee SC
- Angels on Earth Home Care, LLC.
- Colleen Anhalt
- Area Oms
- Callie Aulik
- Aurora Pharmacy Inc
- Autism Center of Wisconsin LLC
- Avada Hearing Care
- Ayaz M. Samadani, MD, SC
All providers in Beaver Dam, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.