DR. JUSTIN SHAWN CUMMINS MD
NPI 1003911603
Orthopaedic Surgery in Ashland, WI
About Dr. Justin Shawn Cummins Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JUSTIN SHAWN CUMMINS MD (NPI 1003911603) is an individual orthopaedic surgery provider in Ashland, Wisconsin, licensed in Wisconsin (53249-20) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with St Lukes Hospital, and is a graduate of University Of Washington School Of Medicine (2002).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Justin Shawn Cummins Md 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.
Medicare Billing Reassignments
2Medicare enrollment records show Justin Cummins reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Ashland, WI 54806
- Reassigned Medicare billing, Wisconsin enrollment
- 175 clinicians in this Medicare group
Hayward, WI 54843
- Reassigned Medicare billing, Wisconsin enrollment
- 104 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
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.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Lukes Hospital
Acute Care Hospitals · Duluth, MNSt Marys Hospital Superior
Critical Access Hospitals · Superior, WITamarack Health Hayward Medical Center
Critical Access Hospitals · Hayward, WITamarack Health Ashland Medical Center
Critical Access Hospitals · Ashland, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54806 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
ASHLAND, WI 54806
ASHLAND, WI 54806
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Justin Cummins's NPI number?
The NPI number for Justin Cummins is 1003911603. It was assigned to this individual provider in the NPPES registry on September 14, 2006.
Where is Justin Cummins located?
Justin Cummins practices at 1615 Maple Lane, Ashland, WI 54806. The listed phone number is (715) 685-5500.
What is Justin Cummins's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.
Is Justin Cummins enrolled in Medicare?
Yes. Justin Cummins is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Justin Cummins's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Justin Cummins reassigns Medicare benefits to 2 organizations: Memorial Medical Center Inc (Ashland, WI) and Medical Services, Inc (Hayward, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justin Cummins's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Justin Cummins accept?
Health plans from Aspirus Health Plan, HealthPartners and Security Health Plan list Justin Cummins as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Justin Cummins affiliated with any hospitals?
According to CMS data, Justin Cummins is affiliated with St Lukes Hospital, St Marys Hospital Superior, Tamarack Health Hayward Medical Center and Tamarack Health Ashland Medical Center.
When was this NPI record last updated?
The NPPES record for Justin Cummins was last updated on August 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.
# Dr. Justin Shawn Cummins, MD · NPI 1003911603
Orthopaedic Surgery physician in Ashland, Wisconsin. Individual provider, active in the CMS NPPES registry since September 14, 2006.
## Identity
- **NPI:** 1003911603 (Entity type: Individual)
- **Enumerated:** September 14, 2006
- **Primary specialty:** Orthopaedic Surgery · taxonomy 207X00000X
- **State license:** 53249-20 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 1615 MAPLE LANE, Ashland, WI 54806
- **Phone:** (715) 685-5500
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Memorial Medical Center Inc (NPI 1437179231, Ashland, WI); Medical Services, Inc (NPI 1912992827, Hayward, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Washington School Of Medicine, class of 2002
## Record status
- **NPPES last updated:** August 29, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1003911603) · Data from the CMS NPPES public registry.