CMS-1500 Box 24J / 33a • NPI
1851383525
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
208D00000X (CMS 01)
Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice
Box 32 Service Location & ZIP+4
3144 VANZILE RD, CRANDON, WI, 54520-8149
✓ 9-Digit EDI 837 ZIP+4 (54520-8149)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1851383525 (GARY M PUSATERI, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1851383525 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | GARY M PUSATERI, MD |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice NUCC Code: 208D00000X (General Practice) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 3144 VANZILE RD, CRANDON, WI, 54520-8149 |
| Practice Telephone / Fax | Tel: (715) 478-5180 |
| Administrative Mailing Address | E23570 POW WOW TRAIL, WATERSMEET, MI, 49969 |
| Enumeration & Last Sync | Enumerated: 2005-08-18 | CMS Record Updated: 2021-05-18 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208D00000X)
What Does Taxonomy Code 208D00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208D00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (GARY M PUSATERI, MD)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
208D00000X — General PracticePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice | State: WI | License: 29938-020 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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