Michael Lee Douglas, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

56257-20 Issued in WI

Practice address

1110 Bergslien Street
Baldwin, WI 54002

Phone

(715) 684-1111

NPI assigned

Sep 26, 2006

Last updated

Jun 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 5

Medicare fee-for-service enrollment

Enrolled in MN, WI, SD, MO4 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 4

Specialty

Family Practice

Education

East Tennessee State University Quillen College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Hospital Webster - Cah Hospital, Webster, SD, CCN 431311

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdouglas357718@direct.myadvocateaurora.org
• Direct secure messaging: mdouglas84271@excellian.direct.allina.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.

• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378

  Family Medicine

  Medicare reassignment NPD
• Baldwin Area Medical Center, Inc.

  dba Western Wisconsin Health

  • Critical Access Hospital
  • Baldwin, WI
  • NPI 1467496133
  Medicare reassignment NPD
• Mercy East Ambulatory Services LLC

  dba Mercy-GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Chesterfield, MO
  • NPI 1134673148
  Medicare reassignment NPD
• Mercy Southern Missouri Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springfield, MO
  • NPI 1871094052
  Medicare reassignment NPD
• Sanford Health Network

  dba Sanford Clinic Webster

  • Family Medicine Physician
  • Webster, SD
  • NPI 1770505760
  Care Compare group NPD
• Sanford Health Network

  dba Sanford Care Center Vermillion

  • Critical Access Hospital
  • Vermillion, SD
  • NPI 1790721280
  Medicare reassignment
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Baldwin Area Medical Center Inc.

  dba Western Wisconsin Health Spring Valley Clinic

  • Clinic/Center
  • Spring Valley, WI
  • NPI 1164272324
  NPD
• Baldwin Area Medical Center, Inc.

  dba Western Wisconsin Health

  • Rural Health Clinic/Center
  • Baldwin, WI
  • NPI 1336228865
  NPD
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552
  NPD
• Sanford Health Network

  dba Sanford Clinic Vermillion

  • Family Medicine Physician
  • Vermillion, SD
  • NPI 1013921733
  NPD

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

• Sanford Health Network

  dba Sanford Webster Medical Center

  • Critical Access Hospital
  • Webster, SD
  • NPI 1831103449
  Care Compare affiliation

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1902907454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BERGSLIEN ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540022600",
            "telephone_number": "715-684-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BERGSLIEN STREET",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "54002",
            "telephone_number": "715-684-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Freeman Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Peter",
            "state": "MN",
            "postal_code": "560823504",
            "country_code": "US",
            "telephone_number": "507-931-7125",
            "fax_number": "507-931-7126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "17115",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "56257-20",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "39759",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100062832",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "227GD3O",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdouglas84271@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1110 Bergslien Street",
            "city": "Baldwin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54002",
            "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": "2600 Kiley Way",
            "city": "Plymouth",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530735020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdouglas357718@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2600 Kiley Way",
            "city": "Plymouth",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530735020",
            "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": "1110 Bergslien Street",
            "city": "Baldwin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdouglas357718@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1110 Bergslien Street",
            "city": "Baldwin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Baldwin, WI
• Providers in Baldwin, 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 10, 2025; 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.