NPIMap

Organization Active NPI

Childrens Medical Group Inc

  • Pediatrics Physician
  • Milwaukee, WI
National Provider Identifier
1790732410
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDRENS MEDICAL GROUP INC
Practice address
9000 W Wisconsin Ave
Ms 958
Milwaukee, WI 53226-3518
Phone
(414) 266-7615
Fax
(414) 266-6238
NPI assigned
May 28, 2006
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Michael Gutzeit, MD
Title
President
Phone
(414) 266-3002

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

9000 W Wisconsin Ave
Ms 958
Milwaukee, WI 53226-3518

Mailing address

9000 W Wisconsin Ave
Ms 958
Milwaukee, WI 53226-3518
Phone (414) 266-7615

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000573 WI Part B Supplier - Clinic/Group Practice 4981509742 Receives reassigned benefits from 10 practitioners
Practice locations: Milwaukee, WI; New Berlin, WI; Oak Creek, WI; Salem, WI; Wauwatosa, WI; Brookfield, WI; Brown Deer, WI; Glendale, WI…

National Provider Directory

National Provider Directory
Tax ID family
CMG Inc Pediatric CNSL38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Locations

9074 N Deerbrook Trl
Brown Deer, WI 53223
Phone (414) 354-7777

6791 N Green Bay Ave
Glendale, WI 53209
Phone (414) 840-2551

6213 10th Ave
Kenosha, WI 53143
Phone (262) 654-8633

6308 8th Ave
#S3070
Kenosha, WI 53143
Phone (262) 652-9430

10046 N Port Washington Rd
Mequon, WI 53092
Phone (262) 240-9744

2025 W Oklahoma Ave
#S105
Milwaukee, WI 53215
Phone (414) 385-9638

2350 W Villard Ave
#S302
Milwaukee, WI 53209
Phone (414) 466-9530

2545 N 29th St
Milwaukee, WI 53210
Phone (414) 264-5338

3239 N 9th St
Milwaukee, WI 53206
Phone (414) 264-0465

3975 N 68th St
#S201
Milwaukee, WI 53216
Phone (414) 536-0236

5757 W Oklahoma Ave
#S105
Milwaukee, WI 53219
Phone (414) 321-3951

24906 75th St
Salem, WI 53168
Phone (262) 654-8633

2500 N Mayfair Rd
#S550
Wauwatosa, WI 53226
Phone (414) 479-9990

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1790732410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263518",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263518",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "GUTZEIT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-266-3002",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.