Michael Gospodarek, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1089033 Issued in WI

Practice address

500 S Oakwood Rd
Oshkosh, WI 54904-7944

Phone

(920) 223-2000

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Anesthesia Services of the Fox Valley SC

  • Anesthesiology Physician
  • Oshkosh, WI
  • NPI 1750385597
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1790736452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 JACKSON ST",
            "address_2": "SUITE E",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549018144",
            "telephone_number": "920-426-2211",
            "fax_number": "920-426-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S OAKWOOD RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047944",
            "telephone_number": "920-223-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSPODAREK",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "1089033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS",
            "identifier": "430059327",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43320400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angeline Fischer Gonzales, SAC-IT
• Jay M Gonzalez, DO
• Debra K. Goodyear, RN
• Logan Goral, DPT
• Baylee Gorges, PHARMD
• Sean Gough
• Shaheda Gene Marie Govani, DDS
• Santosh Gowda, M.D.
• Sheryl L. Graeber
• Graf Family Dentistry

• Certified Registered Nurse Anesthetist in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.