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

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: October 25, 2026.

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Gary Pusateri reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sokaogon Chippewa Community
4.1 mi
Federally Qualified Health Center (FQHC)
3144 VANZILE RD
Crandon, WI 54520
  • Reassigned Medicare billing, Wisconsin enrollment
  • 14 clinicians in this Medicare group
NPI 1033115456 (715) 478-5180

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)
3144 VANZILE RD
CRANDON, WI 54520
Forest County (715) 478-5180
SOKAOGON CHIPPEWA COMMUNITY
Clinic/Center (Federally Qualified Health Center (FQHC))
3144 VANZILE RD
CRANDON, WI 54520
Forest County (715) 478-5180
MRS. SUZETTE LINDA KATCHKO APNP
Nurse Practitioner
3144 VANZILE RD
CRANDON, WI 54520
Forest County (715) 478-5180
MELINDA M ROTH PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
3144 VANZILE RD
CRANDON, WI 54520
Forest County (715) 478-5180
ABIGAIL B ASHBECK LCSW
Social Worker (Clinical)
3144 VANZILE RD
CRANDON, WI 54520
Forest County (715) 478-5180
DR. STEPHANIE MARIE COONS DSW
Social Worker (Clinical)
3144 VANZILE RD
CRANDON, WI 54520
Forest County (715) 478-5180
MR. DAVID R KAUFMAN JR. RPH
Pharmacist
3144 VANZILE RD
CRANDON, WI 54520
Forest County (715) 478-6429
JOLENE A DERFUS SAC-IT
Counselor (Addiction (Substance Use Disorder))
3144 VANZILE RD
CRANDON, WI 54520
Forest County (715) 478-5180

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 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.

Where is Gary Pusateri located?

Gary Pusateri practices at 3144 Vanzile Rd, Crandon, WI 54520. The listed phone number is (715) 478-5180.

What is Gary Pusateri's specialty?

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

Is Gary Pusateri enrolled in Medicare?

Yes. Gary Pusateri is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Gary Pusateri's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Pusateri reassigns Medicare benefits to Sokaogon Chippewa Community (Crandon, 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 Gary Pusateri'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 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.