Individual provider Active NPI

Michael Anthony Pugnale, MD

  • Anesthesiology Physician
  • Kenosha, WI
National Provider Identifier
1881031474
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
101260 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 945-5600
Fax
(262) 948-5735
NPI assigned
May 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036143414 IL
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 125063129 IL
Anesthesiology Physician 207L00000X 101260 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

7503 S Timberlane Dr
Madeira, OH 45243-1847
Phone (614) 314-3334

Other practice location 2

4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 344-5000

Other identifiers 1

IdentifierTypeStateIssuer
100255476MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mpugnale391875@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170717000386 IL Practitioner - Anesthesiology 8628371564 Reassigns benefits to 4 organizations
I20231128001423 WI Practitioner - Anesthesiology 8628371564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Midwest Anesthesia Partners LLCGroup PAC ID 6204737596, 117 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4323

800 W Central Rd
Arlington Heights, IL 60005-2349
Phone (847) 618-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Anesthesiology CurrentSince Jan 2, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Elgin Gastroenterology SC Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2024 Accepting new patients
Illinois Gastroenterology Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Endeavor Health Medical Group Anesthesiology CurrentSince Jan 2, 2024 Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Midwest Anesthesia Partners, LLC Anesthesiology CurrentSince Jul 1, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Chicago Area Partners in Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

Dept 5777
Carol Stream, IL 60122

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

9532 Eagle Way
Chicago, IL 60678

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

101 Waukegan Rd
Ste 980
Lake Bluff, IL 60044
Phone (847) 457-1060

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Interoperability endpoints

  • Direct secure messaging: mpugnale391875@direct.myadvocateaurora.org

Organizations & group practices 12

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1881031474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-945-5600",
            "fax_number": "262-948-5735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7503 S Timberlane Dr",
            "address_purpose": "LOCATION",
            "city": "Madeira",
            "state": "OH",
            "postal_code": "452431847",
            "country_code": "US",
            "telephone_number": "614-314-3334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 W Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508409",
            "country_code": "US",
            "telephone_number": "815-344-5000",
            "fax_number": "815-344-3347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGNALE",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036143414",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "IL",
            "license": "125063129",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "101260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100255476",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpugnale391875@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.