SHERYL A GAUTHIER PA-C
NPI 1114231974
Physician Assistant in Appleton, WI
NPI Status: Active since August 03, 2010
Contact Information
2105 E ENTERPRISE AVE
APPLETON, WI
ZIP 54913
Phone: (920) 560-1000
Fax: (920) 731-6732
- Individual
- Female
- Physician Assistant
- Accepts Insurance
- PECOS Enrolled
About SHERYL GAUTHIER
This page provides the complete NPI Profile along with additional information for Sheryl Gauthier, a primary care provider established in Appleton, Wisconsin with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1114231974 assigned on August 2010. The practitioner's primary taxonomy code is 363A00000X with license number 1087005 (WI). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1114231974
- Provider Name
- SHERYL A GAUTHIER PA-C
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2105 E ENTERPRISE AVE APPLETON, WI 54913
- Location Phone
- (920) 560-1000
- Location Fax
- (920) 731-6732
- Mailing Address
- 801 YORK ST MANITOWOC, WI 54220
- Mailing Phone
- (920) 663-9008
- Mailing Fax
- (920) 731-6732
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-03-2010
- Last Update Date
- 01-02-2025
- Code Navigator
A primary care provider (PCP) like Sheryl Gauthier sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 300 N Commercial St 2
Neenah, WI 54956
(920) 886-0818
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 1087005
- License State
- WI
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- HMO Bronze $0 Medical Deductible - HMO
- HMO Bronze 7500 - HMO
- HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
- HMO Gold 1500 - HMO
- HMO Gold 2400 - HMO
- HMO HDHP Bronze 7200 - HMO
- HMO HDHP Silver 5400 - HMO
- HMO Silver 5000 - HMO
- HMO Silver 6600 - HMO
- POS Bronze 7500 - POS
- POS HDHP Bronze 6250 - POS
- POS Silver 5000 - POS
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
- CGHC Bronze Standard $7500 - Envision Network - EPO
- CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
- CGHC Catastrophic $9200 - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
- CGHC Gold $3000 - Envision Network - EPO
- CGHC Gold $3000 - Envision Network (Vision Exam) - EPO
- CGHC Gold Standard $1500 - Envision Network - EPO
- CGHC Gold Standard $1500 - Envision Network (Vision Exam) - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver Standard $5000 - Envision Network - EPO
- CGHC Silver Standard $5000 - Envision Network (Vision Exam) - EPO
- Prevea360 Bronze HSA - HMO
- Prevea360 Bronze Share - HMO
- Prevea360 Catastrophic - HMO
- Prevea360 Expanded Bronze Standard - HMO
- Prevea360 Gold HSA - HMO
- Prevea360 Gold Share - HMO
- Prevea360 Gold Standard - HMO
- Prevea360 Silver $0 Copay PCP Visits - HMO
- Prevea360 Silver Share - HMO
- Prevea360 Silver Standard - HMO
- Atlas $1,000 Gold - PPO
- Atlas $1,500 Standard Gold - PPO
- Atlas $2,650 Plus Silver - PPO
- Atlas $3,500 HSA Silver - PPO
- Atlas $5,000 Standard Silver - PPO
- Atlas $6,500 Plus Bronze - PPO
- Atlas $7,500 Standard Bronze - PPO
- Atlas $8,200 HSA Bronze - PPO
- Atlas $9,200 Catastrophic - PPO
- Robin Oak $1,000 Gold - PPO
- Robin Oak $1,500 Standard Gold - PPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Silver - HMO
- Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Signature Prestige Bronze $0 Deductible + Dental + Vision - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $0 DED FLAT RX COPAYS - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $7000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $0 DED FLAT RX COPAYS - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $7000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) $9100 DED FLAT RX COPAYS - IL - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - IL - HMO
- Premier $1,500 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,100 HDHP - HMO
- Premier $5,000 - 40% - HMO
- Premier $6,200 HDHP - HMO
- Premier $7,500 - HMO
- Premier $9,200 - HMO
- Premier Protection - HMO
- Premier HMO $1,500 - 30% - HMO
- Premier HMO $2,500 - 20% Copay - HMO
- Premier HMO $3,300 - 30% HDHP - HMO
- Premier HMO $3,500 - 30% - HMO
- Premier HMO $3,500 HDHP - HMO
- Premier HMO $4,000 - 20% HDHP - HMO
- Premier HMO $5,000 - 20% HDHP - HMO
- Premier HMO $5,500 - 30% Copay - HMO
- Premier HMO $7,050 HDHP - HMO
- Premier HMO $750 - 10% - HMO
- Premier HMO $9,100 - HMO
- Premier POS $1,500 - 30% - POS
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1087005 | MEDICAID (05) | WI |
Medicare Participation & PECOS Enrollment Status
Sheryl Gauthier is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 20-29 minutes
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Replacement of knee joint, both sides of knee
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 23 times for 16 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 15 times for 15 patientsTriamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
This service was performed 184 times for 16 patientsA bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.
This service was performed 17 times for 16 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 54913 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.92
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $20.73
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.37
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $16.84
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 1 | 4 | 2 | 3 | 1 | 9 | 7 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 2 | 4 | 4 | 3 | 2 | 9 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 2 + 4 + 4 + 3 + 2 + 9 + 1 + 4 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1114231974 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1174504922 | MRS. MARGARET MARY HAU OT Individual | Occupational Therapist | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (920) 991-2561 |
| 1427025527 | MR. BEN G BENESH PT Individual | Physical Therapist | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (920) 991-2561 |
| 1588617211 | DR. DAVID CHARLES RITZOW M.D. Individual | Orthopaedic Surgery | 2105 E ENTERPRISE AVE STE 111 APPLETON, WI 54913 (920) 731-6611 |
| 1225080955 | MRS. KIM MARIE WILLISON APNP Individual | Nurse Practitioner (Adult Health) | 2105 E ENTERPRISE AVE STE 111 APPLETON, WI 54913 (920) 731-6611 |
| 1114002623 | LARA A BLECK PT Individual | Physical Therapist | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (920) 991-2561 |
| 1770631350 | MS. JESSICA MARIE THEROUX ATC, CSCS Individual | Specialist/Technologist (Athletic Trainer) | 2105 E ENTERPRISE AVE SUITE 113 APPLETON, WI 54913 (920) 991-2561 |
| 1841335742 | MR. JOSHUA ZILM PT Individual | Physical Therapist | 2105 E ENTERPRISE AVE SUITE 113 APPLETON, WI 54913 (920) 991-2561 |
| 1033246442 | MR. RON K LAWRENCE PT Individual | Physical Therapist | 2105 E ENTERPRISE AVE SUITE #113 APPLETON, WI 54913 (920) 991-2561 |
| 1750574711 | FOX VALLEY SURGICAL ASSOCIATES LTD Organization | Non-Pharmacy Dispensing Site | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (952) 653-2528 |
| 1336323260 | MISS AMANDA AUDREY FISCHER CNA Individual | Nurse's Aide | 2105 E ENTERPRISE AVE STE 111 APPLETON, WI 54913 (920) 731-6611 |
| 1275760951 | CHRISTOPHER M O'CONNELL PT Individual | Physical Therapist | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (920) 991-2561 |
| 1144570870 | KENNETH L. SCHAUFELBERGER, M.D., S.C. Organization | Specialist | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (920) 731-3311 |
| 1992049175 | TYLER L VANDERZANDEN PT Individual | Physical Therapist | 2105 E ENTERPRISE AVE SUITE 113 APPLETON, WI 54913 (920) 991-2561 |
| 1912344417 | WILLIAM HAROLD HARTMANN DPT Individual | Physical Therapist (Orthopedic) | 2105 E ENTERPRISE AVE SUITE 113 APPLETON, WI 54913 (920) 991-2561 |
| 1295132496 | FOX VALLEY ORTHOPAEDIC SURGEON'S ASSOCIATION, INC Organization | Orthopaedic Surgery | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (920) 560-1100 |
| 1801287305 | MEGAN LEE ATC Individual | Specialist/Technologist (Athletic Trainer) | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (507) 459-5210 |
| 1285012872 | FOX VALLEY TRANSITIONAL CARE LLC Organization | Skilled Nursing Facility | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (920) 766-6020 |
| 1306195870 | KIRSTEN VON ZYCHLIN PT Individual | Physical Therapist | 2105 E ENTERPRISE AVE SUITE 113 APPLETON, WI 54913 (920) 991-2561 |
| 1679948566 | PADRAIC OBMA, M.D., S.C. Organization | Specialist | 2105 E ENTERPRISE AVE SUITE 112 APPLETON, WI 54913 (920) 731-3111 |
| 1689024812 | ANDREW VERHOEVEN PT, DPT Individual | Physical Therapist | 2105 E ENTERPRISE AVE APPLETON, WI 54913 (920) 991-2561 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114231974, enumerated in the NPI registry as an "individual" on August 03, 2010
The provider is located at 2105 E Enterprise Ave Appleton, Wi 54913 and the phone number is (920) 560-1000
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider might be accepting Accepts: Aspirus Health Plan, Common Ground Healthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $67.37 and an average copayment of 16.84. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Established patient office or other outpatient visit, 20-29 minutes, Injection, triamcinolone acetonide, not otherwise specified, 10 mg and Replacement of knee joint, both sides of knee.
This NPI record was last updated on August 03, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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