NPIMap

Individual provider Active NPI

Joshua Gangl

  • Physician Assistant
  • Wauwatosa, WI
National Provider Identifier
1861019960
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10625 W North Ave Ste 102
Wauwatosa, WI 53226-2315
Phone
(414) 877-5350
NPI assigned
Jul 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

10625 W North Ave Ste 102
Wauwatosa, WI 53226-2315

Mailing address

141 N Jefferson St Apt 405
Milwaukee, WI 53202-6146
Phone (320) 828-1263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211124001049 WI Practitioner - Physician Assistant 4385034834 Reassigns benefits to 1 organization
I20230915002669 MN Practitioner - Physician Assistant 4385034834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

800 E 28TH St
Suite H2100
Minneapolis, MN 55407-3723
Phone (612) 863-3900

PO Box
Suite 43
Minneapolis, MN 55440-0043

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Oct 30, 2023 Accepting new patients
Allina Health System CurrentSince Oct 30, 2023 Accepting new patients
Allina Health System CurrentSince Oct 30, 2023 Accepting new patients
Integrated Therapeutic Massage LLC PastSince Oct 17, 2021 Accepting new patients
Allina Health System Past Accepting new patients

Locations

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

800 E 28th St
Ste H2100
Minneapolis, MN 55407
Phone (612) 863-3900

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

Interoperability endpoints

  • Direct secure messaging: jgangl536590@excellian.direct.allina.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 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1861019960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N JEFFERSON ST APT 405",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532026146",
            "telephone_number": "320-828-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 102",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGL",
        "first_name": "JOSHUA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-06",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.