DR. PHILIP M. DETRANA M.D.
NPI 1013992643
Internal Medicine - Pulmonary Disease in Sheboygan, WI

Active since December 06, 2005PECOS EnrolledAccepts Medicare Assignment
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081(920) 457-4461 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Philip M. Detrana M.d. NPPES

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

DR. PHILIP M. DETRANA M.D. (NPI 1013992643) is an individual pulmonary disease provider in Sheboygan, Wisconsin, licensed in Wisconsin (36416) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Aurora Health Care Central Inc, and is a graduate of R Franklin University Of Med & Sci/chicago Medical School (1986).

NPPES Registry Identity

NPI1013992643
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. PHILIP M. DETRANACredential: M.D.
Location Address2414 KOHLER MEMORIAL DRSheboygan, WI 53081-3129
Mailing Address2414 Kohler Memorial DrSheboygan, WI 53081-3129 · (920) 457-4461
Sole ProprietorYes
Medical School CMSR Franklin University Of Med & Sci/chicago Medical SchoolGraduated 1986
Enumeration DateDecember 6, 2005
Last NPPES UpdateNovember 30, 2021
NPPES CertifiedNovember 30, 2021
NPI 1013992643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in WI · 36416
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 36416 (WI)
2414 KOHLER MEMORIAL DR, Sheboygan, WI 53081

Other Identifiers 1

Medicaid32101500WI

Accepted 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. Philip M. Detrana 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 ID547348898
PECOS Enrollment IDI20110419000886
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.

Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
155 services103 patients
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
Albuterol is a medication used to treat breathing problems. It is administered as an inhalation solution through a device called DME (Durable Medical Equipment). The solution is FDA-approved and non-compounded. Each unit dose contains 1 mg of the medicine.
144 services46 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
114 services104 patients
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.
108 services106 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.
80 services67 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
77 services77 patients

Hospital Affiliations CMS Care Compare

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

Aurora Health Care Central Inc

Acute Care Hospitals · Sheboygan, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520035
Location3400 Union AveSheboygan, WI 53081 · Sheboygan County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
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.

Referred Medical Equipment & Supplies CMS DME claims 25

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
9 suppliers97 claims97 services$35.39 avg. paid by Medicare
Tracheostomy, inner cannula A4623
DME-Orthotic Devices · category DF000N
1 supplier12 claims360 services$5.82 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
4 suppliers11 claims21 services$1.23 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
10 suppliers83 claims83 services$85.97 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
9 suppliers88 claims215 services$31.03 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
8 suppliers49 claims262 services$18.25 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.

Physical Therapist
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Optometrist
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Nurse Practitioner
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Nurse Practitioner (Psychiatric/Mental Health)
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Registered Nurse (Diabetes Educator)
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Family Medicine
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Radiology (Diagnostic Radiology)
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081
Physician Assistant
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081

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 Philip Detrana's NPI number?

The NPI number for Philip Detrana is 1013992643. It was assigned to this individual provider in the NPPES registry on December 6, 2005.

Where is Philip Detrana located?

Philip Detrana practices at 2414 Kohler Memorial Dr, Sheboygan, WI 53081. The listed phone number is (920) 457-4461.

What is Philip Detrana's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Philip Detrana enrolled in Medicare?

Yes. Philip Detrana 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.

What insurance does Philip Detrana accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), Quartz and UnitedHealthcare list Philip Detrana 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 Philip Detrana affiliated with any hospitals?

According to CMS data, Philip Detrana is affiliated with Aurora Health Care Central Inc.

When was this NPI record last updated?

The NPPES record for Philip Detrana was last updated on November 30, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.