Tanya K. Guntly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1354-023 Issued in WI

Practice address

2844 Index Rd
Fitchburg, WI 53713-3117

Phone

(608) 229-7979

Fax

(608) 229-8110

NPI assigned

Jun 3, 2006

Last updated

Apr 1, 2023By 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 2

Addresses

Other identifiers 1

Electronic endpoints 5

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary's Hospital - Madison Hospital, Madison, WI, CCN 520083
• Stoughton Hospital Hospital, Stoughton, WI, CCN 521343

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dean Health Systems, Inc

  dba SSM Health Dean Medical Group

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Dean Health Systems, Inc.

  dba SSM Health Davis Duehr Dean Eye Care - Portage

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

• SSM Health Care of Wisconsin, Inc.

  dba SSM Health St. Mary's Hospital-Madison

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  Care Compare affiliation
• Stoughton Hospital Association

  dba McFarland Urgent Care

  • Urgent Care Clinic/Center
  • McFarland, WI
  • NPI 1477146082

  Hospital

  Care Compare affiliation
• Stoughton Hospital Association

  • Critical Access Hospital
  • Stoughton, WI
  • NPI 1679558647
  Care Compare affiliation
• Stoughton Hospital Association

  dba Cottage Grove Urgent Care

  • Urgent Care Clinic/Center
  • Cottage Grove, WI
  • NPI 1811733066

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680307200000",
    "number": "1932147857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2844 INDEX RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537133117",
            "telephone_number": "608-229-7979",
            "fax_number": "608-229-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 INDEX RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537133117",
            "telephone_number": "608-229-7979",
            "fax_number": "608-229-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTLY",
        "first_name": "TANYA",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2023-04-01",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1354-023",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85004252",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932147857",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tguntly332456@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tguntly332456@direct-ehr-ssmhc.com",
            "address_1": "N2607 County Rd S",
            "city": "Juda",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535509714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "N2607 County Rd S",
            "city": "Juda",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535509714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tguntly332456@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tguntly332456@direct-ehr-ssmhc.com",
            "address_1": "N2607 County Rd S",
            "city": "Juda",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535509714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tguntly332456@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tguntly332456@direct-ehr-ssmhc.com",
            "address_1": "2844 Index Rd",
            "city": "Fitchburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537133117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2844 Index Rd",
            "city": "Fitchburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537133117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Guetschow, COTA
• Erica Guetzlaff, PHARMD
• Guidance Family Homes LLC
• Gullet Transport Solutions LLC
• Karyn C Gullstrand
• Kim Teresa Hackbarth, C.P.N.P.
• Maria Catherine Hackbarth, LMFT
• Carolyn A Haerr, MD
• Liza Hahn, LPC-IT
• Kimberly Haigh

• Physician Assistant in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2023; 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.