DR. ROBERT WILLIAM SEDLACEK M.D.
NPI 1003072687
Family Medicine in Waupaca, WI

Q: What is Robert Sedlacek's NPI number?

The NPI number for Robert Sedlacek is 1003072687. It was assigned to this individual provider in the NPPES registry on August 1, 2008.

Q: What is Robert Sedlacek's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Sedlacek was last updated on November 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.

Active since August 01, 2008PECOS EnrolledAccepts Medicare Assignment

710 RIVERSIDE DR, WAUPACA, WI 54981(715) 256-3000(715) 256-3028 Get Directions Write a Review

NPPES record last updated: November 6, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 6, 2025, May 27, 2020, Jan 14, 2016 (3 updates tracked since 2016).

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About Dr. Robert William Sedlacek M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROBERT WILLIAM SEDLACEK M.D. (NPI 1003072687) is an individual family medicine provider in Waupaca, Wisconsin, licensed in Wisconsin (56001-020) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and is a graduate of Rush Medical College Of Rush University (2008).

NPPES Registry Identity

NPI1003072687

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. ROBERT WILLIAM SEDLACEKCredential: M.D.

Location Address710 RIVERSIDE DRWaupaca, WI 54981-1941

Mailing Address3 Neenah Center, 101 N Commercial StNeenah, WI 54956-3070 · (920) 454-4082 · Fax (920) 830-5910

Phone(715) 256-3000

Fax(715) 256-3028

Sole ProprietorNo

Medical School CMSRush Medical College Of Rush UniversityGraduated 2008

Enumeration DateAugust 1, 2008

Last NPPES UpdateNovember 6, 20253 updates tracked since enumeration

NPPES CertifiedNovember 6, 2025

✔ NPI 1003072687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in WI · 56001-020✔ Licensed in IL · 125.054488✔ Licensed in IL · 036.126371

Definition

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.

710 RIVERSIDE DR, Waupaca, WI 54981

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Robert William Sedlacek M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173792579

PECOS Enrollment IDI20110801000376

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.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

156 services97 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

84 services28 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

53 services53 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This 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.

24 services24 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

24 services15 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

23 services18 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

22 services15 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

20 services20 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

19 services15 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

17 services17 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

15 services15 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

14 services14 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

14 services13 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520045

Location130 2nd StNeenah, WI 54956 · Winnebago County

Emergency services Birthing friendly

Thedacare Medical Center-Waupaca

Critical Access Hospitals · Waupaca, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521334

Location800 Riverside DriveWaupaca, WI 54981 · Waupaca County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54981 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

48%93 patients3/55-star benchmark: 92%

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

88%123 patients4/55-star benchmark: 100%

Cervical Cancer Screening

Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…

31%127 patients

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

62%212 patients3/55-star benchmark: 85%

Depression Utilization of the PHQ-9 Tool

The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit

Patients 4MonthsOfEnd: 45% · 65 patients

Patients 4MonthsOfStart: 22% · 68 patients

64%75 patients

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

32%62 patients2/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%1,784 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

98%3,249 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

36%225 patients2/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

100%73 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

53%548 patients3/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

30%295 patients2/55-star benchmark: 88%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

81%548 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

35%548 patients2/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

31%548 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

4 suppliers16 claims40 services$5.98 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers12 claims19 services$1.01 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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