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NPISignal

Individual Healthcare Provider

P Michael Shattuck, MD

NPI Record: ActiveEmergency Medicine
NPI1740273630
Berlin, Wisconsin

Provider's NPPES record last updated: July 26, 2023

Overview

Entity Type
Individual Healthcare Provider
NPI
1740273630
Primary Specialty
Emergency Medicine
Practice Location
Berlin, Wisconsin
Sole Proprietor
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 18, 2026, 10:52 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Emergency Medicine

    Allopathic & Osteopathic Physicians

    Primary

    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.

    Taxonomy code 207P00000X
  • Family Medicine

    Allopathic & Osteopathic Physicians

    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.

    Taxonomy code 207Q00000X
  • Surgery

    Allopathic & Osteopathic Physicians

    A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

    Taxonomy code 208600000X

Provider-Reported License Information

Emergency Medicine (Wisconsin)
25430
Family Medicine (Wisconsin)
25430-020
Surgery (Wisconsin)
25430-020
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

225 Memorial Dr

Berlin, Wisconsin 54923-1243

Phone: (920) 361-5538

Additional Practice Location

N2934 Highway 22

Wautoma, Wisconsin 54982-0650

Phone: (920) 787-4613

Fax: (920) 787-5433

Record Information

Enumeration Date
August 25, 2005
Provider's NPPES Record Last Updated
July 26, 2023
Certification Date
July 26, 2023
NPISignal NPPES Dataset
August 2026

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