DR. ANDREA MARIA GAVIN MD
NPI 1669587655
Family Medicine in Plymouth, WI
About Dr. Andrea Maria Gavin Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ANDREA MARIA GAVIN MD (NPI 1669587655) is an individual family medicine provider in Plymouth, Wisconsin, licensed in Wisconsin (30392) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Plymouth.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Andrea Maria Gavin Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Andrea Gavin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sheboygan, WI 53081
- Reassigned Medicare billing, Wisconsin enrollment
- 4,609 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 53073 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PLYMOUTH, WI 53073
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 Andrea Gavin's NPI number?
The NPI number for Andrea Gavin is 1669587655. It was assigned to this individual provider in the NPPES registry on August 20, 2006.
Where is Andrea Gavin located?
Andrea Gavin practices at 2600 Kiley Way, Plymouth, WI 53073. The listed phone number is (920) 449-7000.
What is Andrea Gavin's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Andrea Gavin enrolled in Medicare?
Yes. Andrea Gavin is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Andrea Gavin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Gavin reassigns Medicare benefits to Aurora Medical Group, Inc. (Sheboygan, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrea Gavin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Andrea Gavin was last updated on October 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Dr. Andrea Maria Gavin, MD · NPI 1669587655
Family Medicine physician in Plymouth, Wisconsin. Individual provider, active in the CMS NPPES registry since August 20, 2006.
## Identity
- **NPI:** 1669587655 (Entity type: Individual)
- **Enumerated:** August 20, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 30392 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 2600 KILEY WAY, Plymouth, WI 53073-5020
- **Phone:** (920) 449-7000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Aurora Medical Group, Inc. (NPI 1174670244, Sheboygan, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 1, 2024
- **Other identifiers:** Medicaid 31632400 (WI)
---
Source: [NPI Profile](https://npiprofile.com/npi/1669587655) · Data from the CMS NPPES public registry.