Individual provider Active NPI

Gary F Neitzel, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Milwaukee, WI
National Provider Identifier
1962437111
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25373 Issued in WI
Practice address
2900 West Oklahoma Avenue
Milwaukee, WI 53215-4330
Phone
(414) 328-7950
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25373 WI Primary

Addresses

Primary practice location

2900 West Oklahoma Avenue
Milwaukee, WI 53215-4330

Mailing address

8901 West Lincoln Avenue
West Allis, WI 53227-2477
Phone (414) 328-7950

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gneitzel11803@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20040915000096 WI Practitioner - Pathology 4082527387 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25373WIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Pathologists SC Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 1991 Accepting new patients
A2Cl Services, LLC Current Accepting new patients

Locations

252 McHenry St
Burlington, WI 53105
Phone (262) 763-2411

W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1962437111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WEST LINCOLN AVENUE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272477",
            "telephone_number": "414-328-7950",
            "fax_number": "414-328-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 WEST OKLAHOMA AVENUE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-328-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEITZEL",
        "first_name": "GARY",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "25373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gneitzel11803@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "2900 West Oklahoma Avenue",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "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": "2900 West Oklahoma Avenue",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.