DR. JOHN R MCGUIRE MD
NPI 1003869744
Physical Medicine & Rehabilitation in Milwaukee, WI
NPI Status: Active since May 17, 2006
Contact Information
9200 W WISCONSIN AVE
PHYSICAL MEDICINE AND REHABILITATION
MILWAUKEE, WI
ZIP 53226
Phone: (414) 805-7342
Fax: (414) 805-7348
- Individual
- Male
- Years of Experience 39
- Physical Medicine & Rehabilitation
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JOHN MCGUIRE
This page provides the complete NPI Profile along with additional information for John Mcguire, a provider established in Milwaukee, Wisconsin with a medical specialization in Physical Medicine & Rehabilitation and more than 39 years of experience. He graduated from University Of Minnesota Medical School in 1987. The healthcare provider is registered in the NPI registry with number 1003869744 assigned on May 2006. The practitioner's primary taxonomy code is 208100000X with license number 39323 (WI). The provider is registered as an individual and his NPI record was last updated 12 years ago.
- NPI
- 1003869744
- Provider Name
- DR. JOHN R MCGUIRE MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 9200 W WISCONSIN AVE PHYSICAL MEDICINE AND REHABILITATION MILWAUKEE, WI 53226
- Location Phone
- (414) 805-7342
- Location Fax
- (414) 805-7348
- Mailing Address
- 9200 W WISCONSIN AVE PHYSICAL MEDICINE AND REHABILITATION MILWAUKEE, WI 53226
- Mailing Phone
- (414) 805-7342
- Mailing Fax
- (414) 805-7348
- Medical School Name
- UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
- Graduation Year
- 1987
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-17-2006
- Last Update Date
- 05-29-2014
- Code Navigator
Location Map
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
Physical Medicine & Rehabilitation
- Taxonomy Code
- 208100000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 39323
- License State
- WI
- Taxonomy Description
- Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- HMO Bronze $0 Medical Deductible - HMO
- HMO Bronze 10000 - HMO
- HMO Bronze 7500 - HMO
- HMO Catastrophic 10600 with 3 free PCP visits - HMO
- HMO Gold 2000 - HMO
- HMO Gold 2700 - HMO
- HMO HDHP Silver 5900 - HMO
- HMO Silver 6000 - HMO
- HMO Silver 6600 - HMO
- POS Bronze 7500 - POS
- Prestige Bronze $0 Medical Deductible - HMO
- Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
- Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
- Prestige Bronze Essential + 3 Free PCP Visits - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
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.
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 |
|---|---|---|---|
| 1003869744 | MEDICAID (05) | WI | |
| F40414 | MEDICARE UPIN (02) | ||
| 680861272 | MEDICARE PIN (08) | WI | |
| 051473601 | MEDICARE PIN (08) | WI | |
| 002000215T | OTHER (01) | HUMANA | |
| 007832064 | MEDICARE PIN (08) | WI |
Medicare Participation & PECOS Enrollment Status
John Mcguire is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
John Mcguire 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
PECOS PAC ID: 6406934439
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20080416000437
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE000N)
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes (HCPCS:K0739)
2 DME suppliers used 13 Medicare Claims 61 Services Paid
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.
Follow-up hospital inpatient care per day, typically 35 minutes
Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity
Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity
Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity
Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, each additional extremity
Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity
Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity
Injection of chemical for paralysis of nerve muscles on side of face
Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box
Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box
Injection of chemical for paralysis of nerve muscles on trunk, 1-5 muscles
Injection, onabotulinumtoxina, 1 unit
Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle
Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle
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.
This service was performed 61 times for 24 patientsThis procedure involves injecting a special chemical into 1-4 muscles in an arm or leg to temporarily paralyze them. This can help manage pain or muscle disorders. If needed, the process can be repeated on an additional limb.
This service was performed 201 times for 59 patientsThis procedure involves injecting a special chemical into 1-4 muscles in an arm or leg to temporarily paralyze them. This can help manage pain or muscle disorders. If needed, the process can be repeated on an additional limb.
This service was performed 55 times for 15 patientsThis procedure involves injecting a chemical into specific muscles in your arm or leg, causing temporary paralysis. It targets 1-4 muscles in the first extremity. It's often used to manage conditions that cause muscle spasms or overactivity.
This service was performed 75 times for 29 patientsThis procedure involves injecting a chemical into specific muscles in an arm or leg to temporarily paralyze them. It's often used to manage muscle spasms or movement disorders. If more than 5 muscles are treated in additional limbs, it's considered a separate service.
This service was performed 85 times for 32 patientsThis procedure involves injecting a chemical into specific muscles in an arm or leg to temporarily paralyze them. It's typically used to manage muscular disorders or reduce muscle activity. The process targets 5 or more muscles in the first extremity.
This service was performed 185 times for 73 patientsThis procedure involves injecting a chemical into specific muscles in an arm or leg to temporarily paralyze them. It's typically used to manage muscular disorders or reduce muscle activity. The process targets 5 or more muscles in the first extremity.
This service was performed 32 times for 11 patientsThis procedure involves injecting a chemical into specific facial nerves, causing temporary muscle paralysis. It's used to treat conditions like facial spasms or wrinkles. The effects are usually temporary, requiring repeat treatments.
This service was performed 35 times for 11 patientsThis procedure involves injecting a chemical into specific neck muscles, causing temporary paralysis. It's designed to alleviate symptoms related to nerve disorders. The voice box isn't affected, ensuring normal speech post-procedure.
This service was performed 103 times for 39 patientsThis procedure involves injecting a chemical into specific neck muscles, causing temporary paralysis. It's designed to alleviate symptoms related to nerve disorders. The voice box isn't affected, ensuring normal speech post-procedure.
This service was performed 33 times for 12 patientsThis procedure involves injecting a special chemical into 1-5 muscles in your body's trunk region. The chemical temporarily paralyzes these muscles, easing pain or discomfort. It's a safe, commonly performed process and any effects are usually temporary.
This service was performed 95 times for 37 patientsOnabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
This service was performed 21,500 times for 19 patientsThis procedure involves a needle that measures the electrical activity in your muscles. A chemical is then injected to temporarily paralyze the nerve muscle. This helps in diagnosing and treating certain muscle or nerve conditions.
This service was performed 306 times for 118 patientsThis procedure involves a needle that measures the electrical activity in your muscles. A chemical is then injected to temporarily paralyze the nerve muscle. This helps in diagnosing and treating certain muscle or nerve conditions.
This service was performed 72 times for 27 patientsFind Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. John Mcguire is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| FROEDTERT MEMORIAL LUTHERAN HOSPITAL | 9200 W WISCONSIN AVE MILWAUKEE, WI 53226 | (414) 805-3000 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003869744, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003869744, enumerated as an "individual" on May 17, 2006.
The provider is located at 9200 W WISCONSIN AVE PHYSICAL MEDICINE AND REHABILITATION MILWAUKEE, WI 53226 and the phone number is (414) 805-7342.
Physical Medicine & Rehabilitation with taxonomy code 208100000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to verify.
John Mcguire is affiliated with: FROEDTERT MEMORIAL LUTHERAN HOSPITAL.
