Individual provider Active NPI

Todd M Gudausky, M.D.

  • Pediatric Cardiology Physician
  • Milwaukee, WI
National Provider Identifier
1881604932
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
51296 Issued in WI
Practice address
9000 W Wisconsin Ave
Pediatric Cardiology
Milwaukee, WI 53226-4874
Phone
(414) 266-6457
Fax
(414) 266-2294
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 51296 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Pediatric Cardiology
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Pediatric Cardiology
Milwaukee, WI 53226-4874
Phone (414) 266-6457

Other practice location 1

6809 122nd Strate
Kenosha, WI 53142
Phone (414) 266-6457

Other practice location 2

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6000

Other identifiers 1

IdentifierTypeStateIssuer
1881604932MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgudausky1257506@direct.uwhealth.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080423000391 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7012912470 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51296WIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jun 6, 2022 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Dec 28, 2013 Accepting new patients
Children'S Specialty Group, Inc. CurrentSince Feb 13, 2024 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jun 6, 2022 Accepting new patients

Locations

6809 122nd Ave
Kenosha, WI 53142
Phone (262) 654-8633

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

1320 Wisconsin Ave
Racine, WI 53403
Phone (262) 687-2222

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: tgudausky5964@direct.chw.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1881604932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC CARDIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6457",
            "fax_number": "414-266-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC CARDIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6457",
            "fax_number": "414-266-2294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6809 122nd Strate",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "53142",
            "country_code": "US",
            "telephone_number": "414-266-6457",
            "fax_number": "414-266-3261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-6000",
            "fax_number": "414-805-6280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDAUSKY",
        "first_name": "TODD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WI",
            "license": "51296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881604932",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgudausky1257506@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "9000 W Wisconsin Ave",
            "address_2": "PEDIATRIC CARDIOLOGY",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532264874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.