MICHELLE LOUISE GAUTHIER DO
NPI 1265489264
Family Medicine in Pleasant Prairie, WI

Q: What is Michelle Gauthier's NPI number?

The NPI number for Michelle Gauthier is 1265489264. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Q: What is Michelle Gauthier's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Michelle Gauthier was last updated on December 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 27, 2006PECOS EnrolledAccepts Medicare Assignment

79.61/100

CMS Quality Rating

9697 SAINT CATHERINES DR, PLEASANT PRAIRIE, WI 53158(262) 577-8320(262) 577-8372 Get Directions Write a Review

NPPES record last updated: December 3, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Michelle Louise Gauthier Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELLE LOUISE GAUTHIER DO (NPI 1265489264) is an individual family medicine provider in Pleasant Prairie, Wisconsin, licensed in Wisconsin (39272) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (1996).

NPPES Registry Identity

NPI1265489264

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMICHELLE LOUISE GAUTHIERCredential: DO

Location Address9697 SAINT CATHERINES DRPleasant Prairie, WI 53158-2118

Mailing Address9697 Saint Catherines DrPleasant Prairie, WI 53158-2118 · (262) 577-8320 · Fax (262) 577-8372

Phone(262) 577-8320

Fax(262) 577-8372

Sole ProprietorNo

Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 1996

Enumeration DateMay 27, 2006

Last NPPES UpdateDecember 3, 2018

✔ NPI 1265489264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 39272

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

9697 SAINT CATHERINES DR, Pleasant Prairie, WI 53158

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Other Identifiers 2

Other081091455WI · Medicare Rr

Medicaid43499900WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michelle Louise Gauthier Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7719170661

PECOS Enrollment IDI20101022001266

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

568 services338 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

160 services130 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

156 services76 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

155 services65 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

92 services74 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

90 services76 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

42 services37 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

22 services22 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

20 services20 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

14 services14 patients

Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53158 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.61/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

70.88

Promoting Interoperability

100

Improvement Activities

Cost

61.15

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

13 suppliers82 claims153 services$5.70 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

11 suppliers30 claims31 services$0.92 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407

DME-Orthotic Devices · category DF010N

3 suppliers17 claims570 services$7.84 avg. paid by Medicare

Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425

DME-Orthotic Devices · category DF010N

2 suppliers13 claims330 services$3.46 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier19 claims19 services$15.87 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers26 claims26 services$24.54 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN LEE PA-C

Physician Assistant

9697 SAINT CATHERINES DR
PLEASANT PRAIRIE, WI 53158

Kenosha County (262) 656-3590

LARONDA JAMES NURSE PRACTITIONER

Nurse Practitioner

9697 SAINT CATHERINES DR
PLEASANT PRAIRIE, WI 53158

Kenosha County (262) 656-3338

MHD ANAS ALSAWAF MBBS, MD

Orthopaedic Surgery

9697 SAINT CATHERINES DR, STE 200
PLEASANT PRAIRIE, WI 53158

Kenosha County (262) 656-3590

DR. NICHOLAS CAIN PT, DPT

Physical Therapist (Sports)

9697 SAINT CATHERINES DR
PLEASANT PRAIRIE, WI 53158

Kenosha County (262) 577-8141

ABDUL SAMI KHAN MD

Internal Medicine (Gastroenterology)

9697 SAINT CATHERINES DR
PLEASANT PRAIRIE, WI 53158

Kenosha County (262) 653-5330

PAIN CENTERS OF WISCONSIN - KENOSHA, LLC

Clinic/Center (Ambulatory Surgical)

9697 SAINT CATHERINES DR, STE 102
PLEASANT PRAIRIE, WI 53158

Kenosha County (414) 325-7246

DR. ALAN P. GEGENHEIMER D.O.

Orthopaedic Surgery

9697 SAINT CATHERINES DR, SUITE 200
PLEASANT PRAIRIE, WI 53158

Kenosha County (262) 656-3590

ADVANCED PAIN MANAGEMENT SC

Durable Medical Equipment & Medical Supplies

9697 SAINT CATHERINES DR, SUITE 101
PLEASANT PRAIRIE, WI 53158

Kenosha County (414) 325-7246

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michelle Gauthier's NPI number?

The NPI number for Michelle Gauthier is 1265489264. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Where is Michelle Gauthier located?

Michelle Gauthier practices at 9697 Saint Catherines Dr, Pleasant Prairie, WI 53158. The listed phone number is (262) 577-8320.

What is Michelle Gauthier's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Michelle Gauthier enrolled in Medicare?

Yes. Michelle Gauthier is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michelle Gauthier accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Anthem Blue Cross and Blue Shield and Network Health list Michelle Gauthier as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Michelle Gauthier affiliated with any hospitals?

According to CMS data, Michelle Gauthier is affiliated with Froedtert South Inc..

When was this NPI record last updated?

The NPPES record for Michelle Gauthier was last updated on December 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.