DR. MICHAEL HERBERT HOFFMAN MD NPI 1013080894
Family Medicine in Manitowoc, WI

About DR. MICHAEL HERBERT HOFFMAN MD

Michael Hoffman is a primary care provider established in Manitowoc, Wisconsin and his medical specialization is Family Medicine with more than 30 years of experience. He graduated from University Of Wisconsin School Of Medicine in 1993. The NPI number of Michael Hoffman is 1013080894 and was assigned on November 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 37805 (WI). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1013080894
Provider NameDR. MICHAEL HERBERT HOFFMAN MD
Location Address3415 CUSTER ST SUITE D MANITOWOC, WI 54220
Location Phone(920) 652-9310
Mailing Address3415 CUSTER ST SUITE D MANITOWOC, WI 54220
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduation Year1993
Is Sole Proprietor?No
Enumeration Date11-17-2006
Last Update Date04-30-2014

A primary care provider (PCP) like Dr. Michael Herbert Hoffman Md 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 Michael Hoffman 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.

Michael Hoffman is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Bellin Memorial Hospital and Holy Family Memorial.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.4 for a new patient copayment and $24.86 for an established patient copayment.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.37805
License StateWI
Taxonomy DescriptionFamily 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.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

DR. MICHAEL HERBERT HOFFMAN MD
3415 CUSTER ST
SUITE D
MANITOWOC, WI
ZIP 54220
Phone: (920) 652-9310

Get Directions


Mailing Address

DR. MICHAEL HERBERT HOFFMAN MD
3415 CUSTER ST
SUITE D
MANITOWOC, WI
ZIP 54220
Phone: (920) 652-9310


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID4880628585
PECOS Enrollment IDI20050922000237
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 54220 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$55.63 $169.16 $85.6
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.9 $42.29 $21.4
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.46 $138.8 $99.45
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.36 $34.7 $24.86

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 317Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 102Hemoglobin A1C level (HCPCS:83036)
  • 45Administration of influenza virus vaccine (HCPCS:G0008)
  • 40Automated urinalysis test (HCPCS:81003)
  • 35X-ray of chest, 2 views, front and side (HCPCS:71020)
  • 32Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • 20Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 13Administration of pneumococcal vaccine (HCPCS:G0009)
  • 11X-ray of abdomen, single view (HCPCS:74000)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Michael Hoffman is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
BELLIN MEMORIAL HOSPITAL744 S WEBSTER AVE
GREEN BAY, WI 54305
(920) 433-3500Acute Care Hospitals520049
HOLY FAMILY MEMORIAL2300 WESTERN AVE
MANITOWOC, WI 54221
(920) 320-2011Acute Care Hospitals520107

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
WI1119003MEDICARE OSCAR/CERTIFICATION (06)WI
G32676MEDICARE UPIN (02)
002150264MEDICARE OSCAR/CERTIFICATION (06)WI
430800027MEDICARE OSCAR/CERTIFICATION (06)WI
072900049MEDICARE OSCAR/CERTIFICATION (06)WI
WI1097008MEDICARE OSCAR/CERTIFICATION (06)WI
008770101MEDICARE OSCAR/CERTIFICATION (06)WI
002150203MEDICARE OSCAR/CERTIFICATION (06)WI

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.
1013080894
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023080818
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 8 + 0 + 8 + 1 + 8 + 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 = 44

The NPI number 1013080894 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 15 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1679558894 ANN MARIE VERLARE LCSW
Individual
Social Worker3415 CUSTER ST SUITE D
MANITOWOC, WI 54220
(920) 433-3630
1568788719 DIONNE M CENTNER
Individual
Case Manager/Care Coordinator3415 CUSTER ST SUITE C
MANITOWOC, WI 54220
(920) 562-2469
1447576608 ROXANNE D TAYLOR
Individual
Registered Nurse (Case Management)3415 CUSTER ST SUITE 2
MANITOWOC, WI 54220
(920) 652-2440
1407172653 SANDRA DREVS
Individual
Case Manager/Care Coordinator3415 CUSTER ST
MANITOWOC, WI 54220
(920) 652-2440
1841516804 KIM HYNEK
Individual
Registered Nurse (Case Management)3415 CUSTER ST SUITE C
MANITOWOC, WI 54220
(920) 652-2440
1942506928 RACHEL LYNN SCHROEDER
Individual
Case Manager/Care Coordinator3415 CUSTER ST
MANITOWOC, WI 54220
(920) 652-2190
1689969008 AMBER LEE GRALL B.A. SOCIAL WORK
Individual
Case Manager/Care Coordinator3415 CUSTER ST
MANITOWOC, WI 54220
(920) 652-2440
1760760045 GLADYS R TIENOR RN
Individual
Registered Nurse (Case Management)3415 CUSTER ST
MANITOWOC, WI 54220
(920) 652-8721
1164788451 TRISH LUANN GORDON
Individual
Case Manager/Care Coordinator3415 CUSTER ST SUITE C
MANITOWOC, WI 54220
(920) 652-2440
1073879367 SIGHLE MLEZIVA
Individual
Registered Nurse (Case Management)3415 CUSTER ST SUITE C
MANITOWOC, WI 54220
(920) 652-2440
1588992275BELLIN PSYCHIATRIC CENTER INC
Organization
Clinic/Center (Mental Health (Including Community Mental Health Center))3415 CUSTER ST SUITE D
MANITOWOC, WI 54220
(920) 652-9310
1841834678 STEPHEN ROBERT SEIFERT RD,CD
Individual
Dietitian, Registered3415 CUSTER ST
MANITOWOC, WI 54220
(920) 652-9310
1427294701BELLIN MEMORIAL HOSPITAL INC
Organization
Family Medicine3415 CUSTER ST SUITE D
MANITOWOC, WI 54220
(920) 652-9310
1396006821 ERIN M ZIMBAL PT
Individual
Physical Therapist3415 CUSTER ST SUITE D
MANITOWOC, WI 54220
(920) 652-9310
1740265214 TAMMI S GAGS PA
Individual
Physician Assistant3415 CUSTER ST
MANITOWOC, WI 54220
(920) 652-9310

Frequently Asked Questions

What is Dr. Michael Hoffman MD NPI number?

The NPI number assigned to Dr. Michael Hoffman MD is 1013080894, registered as an "individual" on November 17, 2006

Where is Dr. Michael Hoffman MD located?

The provider is located at 3415 Custer St Suite D Manitowoc, Wi 54220 and the phone number is (920) 652-9310

Which is Dr. Michael Hoffman MD specialty?

The provider's speciality is Family Medicine

How many years of experience does Dr. Michael Hoffman MD have?

The provider has more than 30 years of experience. He graduated from University Of Wisconsin School Of Medicine in 1993.

What insurance does Dr. Michael Hoffman MD accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Michael Hoffman MD registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.

How much is a visit to Dr. Michael Hoffman MD?

Medicare beneficiaries should expect a typical cost of $85.6 with an average copayment of $21.4 for new patient appointments. Established patients should expect a typical charge of $99.45 and an average copayment of 24.86. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Michael Hoffman MD?

The most common procedures or services performed by this practitioner are: Insertion of needle into vein for collection of blood sample, Hemoglobin A1C level, Administration of influenza virus vaccine, Automated urinalysis test, X-ray of chest, 2 views, front and side, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Routine EKG using at least 12 leads including interpretation and report, Administration of pneumococcal vaccine and X-ray of abdomen, single view.

Is Dr. Michael Hoffman MD affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: BELLIN MEMORIAL HOSPITAL and HOLY FAMILY MEMORIAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Dr. Michael Hoffman MD was last updated on November 17, 2006. 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]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]