Mary J Gentine, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

40128-020 Issued in WI

Practice address

1703 N Taylor Dr
Sheboygan, WI 53081-1933

Phone

(920) 457-4438

Fax

(920) 457-6748

NPI assigned

May 4, 2006

Last updated

Jun 12, 2012By the provider in NPPES

Sex

Female

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 1

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

Specialty

Family Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora at Home Home health agency, Green Bay, WI, CCN 527302
• Preceptor Home Health Home health agency, Germantown, WI, CCN 527313
• Sharon S Richardson Community Hospice Hospice, Sheboygan Falls, WI, CCN 521582
• Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107
• St Nicholas Hospital Hospital, Sheboygan, WI, CCN 520044
• Aurora Medical Center Sheboygan County Hospital, Sheboygan, WI, CCN 520035

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgentine146774@direct.froedtert.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Froedtert Manitowoc Medical Group, LLC

  dba Froedtert Northeast Medical Group

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• DRS. Massaro & Kalenak S C

  • Ophthalmology Physician
  • Milwaukee, WI
  • NPI 1558482364
  NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aurora Health Care Central, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sheboygan, WI
  • NPI 1902023955

  Hospital

  Care Compare affiliation
• Aurora Health Care Central, Inc.

  dba Aurora Medical Center Sheboygan County

  • General Acute Care Hospital
  • Sheboygan, WI
  • NPI 1922053107
  Care Compare affiliation
• Great Lakes Healthcare, Inc.

  dba Preceptor Home Health

  • Home Health Agency
  • Germantown, WI
  • NPI 1255996740
  Care Compare affiliation
• Holy Family Memorial Inc

  dba Froedtert Holy Family Memorial Hospital

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  Care Compare affiliation
• Sharon S. Richardson Hospice Home, Inc

  dba Sharon S. Richardson Community Hospice, Inc.

  • Community Based Hospice Care Agency
  • Sheboygan Falls, WI
  • NPI 1598855207
  Care Compare affiliation
• St Nicholas Hospital-Sisters of the Third Order of St. Francis

  dba St. Nicholas Hospital Renal Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sheboygan, WI
  • NPI 1427009992

  Hospital

  Care Compare affiliation
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  dba St Nicholas Hospital

  • General Acute Care Hospital
  • Sheboygan, WI
  • NPI 1730184342
  Care Compare affiliation
• Visiting Nurse Association of Wisconsin, Inc

  dba Aurora at Home

  • Home Health Agency
  • Green Bay, WI
  • NPI 1932361763
  Care Compare affiliation

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1811945942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "920-457-4438",
            "fax_number": "920-457-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811933",
            "telephone_number": "920-457-4438",
            "fax_number": "920-457-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTINE",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "40128-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33332800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• GBR Sheboygan LLC
• Max Jason Geers, M.D.
• Charles J Gehring Jr., MD
• Kenneth Edward Geiger, D.D.S.
• Lynn Marie Geiser, MS, MFT-IT, PC-IT
• Georgebee Home Healthcare LLC
• Leslie C Gerbitz, PT
• Amy Germain, DNP
• Katie Gesch, D.O., M.S.
• Jennifer Giebel, APNP

• Family Medicine Physician in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.