MICHAEL L. DOUGLAS M.D. – NPI #1902907454
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

MICHAEL DOUGLAS is a physician located in BALDWIN, WI. NPPES has assigned the NPI number 1902907454 to MICHAEL DOUGLAS on September 26, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was last updated on Jun 10, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MICHAEL DOUGLAS below.

NPI Profile for
MICHAEL L. DOUGLAS

NPI Number
1902907454
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
MICHAEL L. DOUGLAS
Credentials
M.D.
Primary location
1110 BERGSLIEN STREET
BALDWIN, WI 54002
Phone: (715) 684-1111 Fax:
1 Other location(s):
100 Freeman Dr
Saint Peter, MN 56082-3504
Phone: (507) 931-7125
Fax: (507) 931-7126
Mailing address
1100 BERGSLIEN ST
BALDWIN, WI 54002-2600
Phone: (715) 684-1111 Fax:
Sole Proprietor
No
Updated
Certification Date
Jun 10, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MICHAEL DOUGLAS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherBLUE CROSS/BLUE SHIELDMN227GD3O
medicaidWI100062832
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
WI 56257-20
207QG0300X
- Family Medicine / Geriatric Medicine
MN 39759

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
1110 BERGSLIEN STREET,
BALDWIN, WI 77025-1669

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
2600 KILEY WAY,
PLYMOUTH, WI 77025-1669

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
OTHER
Affiliation
N
Endpoint Location
1110 BERGSLIEN STREET,
BALDWIN, WI 77025-1669

Endpoint
https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Endpoint type
FHIR URL
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
1110 BERGSLIEN STREET,
BALDWIN, WI 77025-1669

Endpoint
https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Endpoint type
FHIR URL
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
2600 KILEY WAY,
PLYMOUTH, WI 77025-1669

Additional Information

Education
EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE - Graduated 1994
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
MICHAEL DOUGLAS is affiliated with the following medical group(s):
  • HOSPITAL
    • ALLINA UNITED HOSPITAL
      333 NORTH SMITH AVENUE
      SAINT PAUL, MN 55102
    • WESTERN WISCONSIN HEALTH
      1100 BERGSLIEN ST
      BALDWIN, WI 54002
  • HOME HEALTH AGENCY
    • ADORAY HOME HEALTH AND HOSPICE
      990 MAIN ST, SUITE 1
      BALDWIN, WI 54002

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.