Individual provider Active NPI

Rick D Gillis, MD

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1962453746
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30397 Issued in WI
Practice address
840 N 87TH St
Sargeant Health Center
Milwaukee, WI 53226-3586
Phone
(414) 805-5540
Fax
(414) 805-7878
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30397 WI Primary

Addresses

Primary practice location

840 N 87TH St
Sargeant Health Center
Milwaukee, WI 53226-3586

Mailing address

840 N 87TH St
Sargeant Health Center
Milwaukee, WI 53226-3586
Phone (414) 805-5540

Other identifiers 3

IdentifierTypeStateIssuer
1962453746MedicaidWI
002000117GOtherHUMANA
110088240OtherRAILROAD MEDICARE

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
I20050913000343 WI Practitioner - Internal Medicine 1557394327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1155 N Mayfair Rd
Wauwatosa, WI 53226-3462
Phone (414) 955-5990

1271 N 6TH St
Milwaukee, WI 53212-3360
Phone (414) 978-9100

840 N 87TH St
Milwaukee, WI 53226-3586
Phone (414) 805-5540

Hospital & facility affiliations

  • Horizon Home Care and Hospice Home health agency, Milwaukee, WI, CCN 527083
  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • St Josephs Community Hospital West Bend Hospital, West Bend, WI, CCN 520063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30397WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 5, 2013 Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Jun 30, 1991 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine Current Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

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

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

Interoperability endpoints

  • Direct secure messaging: rgillismd272@direct.froedtert.com

Organizations & group practices 3

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 5

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1962453746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 N 87TH ST",
            "address_2": "SARGEANT HEALTH CENTER",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263586",
            "telephone_number": "414-805-5540",
            "fax_number": "414-805-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N 87TH ST",
            "address_2": "SARGEANT HEALTH CENTER",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263586",
            "telephone_number": "414-805-5540",
            "fax_number": "414-805-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "RICK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "30397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962453746",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002000117G",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110088240",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.