MR. GARY M PUSATERI MD
NPI 1851383525
General Practice in Crandon, WI

Q: What is Gary Pusateri's NPI number?

The NPI number for Gary Pusateri is 1851383525. It was assigned to this individual provider in the NPPES registry on August 18, 2005.

Q: What is Gary Pusateri's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Gary Pusateri was last updated on May 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 August 18, 2005PECOS Enrolled

3144 VANZILE RD, CRANDON, WI 54520(715) 478-5180 Get Directions Write a Review

NPPES record last updated: May 18, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Gary M Pusateri Md NPPES

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

MR. GARY M PUSATERI MD (NPI 1851383525) is an individual general practice provider in Crandon, Wisconsin, licensed in Wisconsin (29938-020) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851383525

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameMR. GARY M PUSATERICredential: MD

Location Address3144 VANZILE RDCrandon, WI 54520-8149

Mailing AddressE23570 Pow Wow TrailWatersmeet, MI 49969 · (906) 358-4588 · Fax (906) 358-4588

Phone(715) 478-5180

Sole ProprietorNo

Enumeration DateAugust 18, 2005

Last NPPES UpdateMay 18, 2021

NPPES CertifiedMay 18, 2021

✔ NPI 1851383525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in WI · 29938-020

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

3144 VANZILE RD, Crandon, WI 54520

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Other Identifiers 1

Medicaid31543400WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Gary M Pusateri 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.

Other Providers at the Same Location NPPES 14

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

KRISTEN RADLOFF FNP, APNP

Nurse Practitioner (Family)