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P MICHAEL SHATTUCK MD
NPI 1740273630
Emergency Medicine in Berlin, WI

Active since August 25, 2005PECOS Enrolled
225 MEMORIAL DR, BERLIN, WI 54923(920) 361-5538(920) 361-5499 Get Directions Write a Review

NPPES record last updated: July 26, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 26, 2023, Apr 8, 2019 (2 updates tracked since 2019).

About P Michael Shattuck Md NPPES

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

P MICHAEL SHATTUCK MD (NPI 1740273630) is an individual emergency medicine provider in Berlin, Wisconsin, licensed in Wisconsin (25430) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740273630
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameP MICHAEL SHATTUCKCredential: MD
Location Address225 MEMORIAL DRBerlin, WI 54923-1243
Mailing Address225 Memorial DrBerlin, WI 54923-1243 · (920) 361-1313 · Fax (920) 361-5499
Phone(920) 361-5538
Fax(920) 361-5499
Sole ProprietorNo
Enumeration DateAugust 25, 2005
Last NPPES UpdateJuly 26, 20232 updates tracked since enumeration
NPPES CertifiedJuly 26, 2023
✔ NPI 1740273630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in WI · 25430
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 25430-020 (WI)
Also ListedSurgeryTaxonomy 208600000X · License 25430-020 (WI)
225 MEMORIAL DR, Berlin, WI 54923
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Other Names 1

Other Name (5)Paul Shattuck Md

Other Identifiers 1

Medicaid30668600WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

P Michael Shattuck Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54923 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.

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.

DR. COURTNEY DISTERHAFT DPT
Physical Therapist
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-1313
BARRY L ROGERS MD
Surgery
225 MEMORIAL DR, STE 2000
BERLIN, WI 54923
Green Lake County (920) 361-5340
CENTRAL WISCONSIN ANESTHESI
Anesthesiology
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-5538
JESSICA JO TOMASIEWICZ
Nurse Anesthetist, Certified Registered
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-5538
DR. JAMES S HEINZEN M.D.
Emergency Medicine
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-5525
EMILY ANNE RADEMACHER COTA
Occupational Therapy Assistant
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-1313
DANIEL KENNETH LEMBERGER APNP
Nurse Practitioner (Adult Health)
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-1313
TONY D SINGH CRNA
Nurse Anesthetist, Certified Registered
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-5538

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 P Shattuck's NPI number?

The NPI number for P Shattuck is 1740273630. It was assigned to this individual provider in the NPPES registry on August 25, 2005. The provider is also known as Paul Shattuck MD.

Where is P Shattuck located?

P Shattuck practices at 225 Memorial Dr, Berlin, WI 54923. The listed phone number is (920) 361-5538.

What is P Shattuck's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is P Shattuck enrolled in Medicare?

Yes. P Shattuck is registered in the Medicare PECOS enrollment system.

What insurance does P Shattuck accept?

Health plans from Medica list P Shattuck 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.

When was this NPI record last updated?

The NPPES record for P Shattuck was last updated on July 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.