PETER A ROLOFF MD
NPI 1023002110
Pediatrics in Pewaukee, WI

NPI Status: Active since September 06, 2005

Contact Information

1215 GEORGE TOWNE DR
PEWAUKEE, WI
ZIP 53072
Phone: (262) 691-3849
Fax: (262) 691-4287

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Pediatrics
Accepts Insurance
PECOS Enrolled
Medicare Quality Reporting

About PETER ROLOFF

This page provides the complete NPI Profile along with additional information for Peter Roloff, a pediatrician established in Pewaukee, Wisconsin with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1023002110 assigned on September 2005. The practitioner's primary taxonomy code is 208000000X with license number 41886 (WI). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI: 1023002110
Provider Name: PETER A ROLOFF MD
Gender: Male
Entity Type: Individual
Location Address: 1215 GEORGE TOWNE DR PEWAUKEE, WI 53072
Location Phone: (262) 691-3849
Location Fax: (262) 691-4287
Mailing Address: 1215 GEORGE TOWNE DR PEWAUKEE, WI 53072
Mailing Phone: (262) 691-3849
Mailing Fax: (262) 691-4287
Is Sole Proprietor?: No
Enumeration Date: 09-06-2005
Last Update Date: 12-29-2023
Code Navigator

A pediatrician like Peter Roloff is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

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: Pediatrics
Taxonomy Code: 208000000X
Type: Allopathic & Osteopathic Physicians
License No.: 41886
License State: WI
Taxonomy Description: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
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 Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
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

Aspirus Health Plan

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

CareSource (Common Ground Healthcare)

CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
CareSource (Common Ground Healthcare) Gold $3300 - EPO
CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO

HealthPartners

NE WI Select $3,150 Plus Silver - PPO
NE WI Select $3,800 HSA Silver - PPO
NE WI Select $6,000 Standard Silver - PPO
NE WI Select $6,800 Plus Bronze HSA - PPO
NE WI Select $7,500 Standard Bronze HSA - PPO
NE WI Select $8,400 HSA Bronze - PPO
Oak $1,300 Gold - PPO
Oak $2,000 Standard Gold - PPO

Network Health

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

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Bronze Standard (No Referrals) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Gold Standard (No Referrals) - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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
32626800	MEDICAID (05)	WI

Medicare Participation & PECOS Enrollment Status

Peter Roloff 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
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

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.

Adm sarscov2 30mcg/0.3ml bst
Administration of influenza virus vaccine
Influenza vaccine split virus, preservative free
Insertion of needle into vein for collection of blood sample

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53072 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $82.92
Minimum New Patient Price $53.9
Maximum New Patient Price $163.24

Average New Patient Copayment $20.73
Minimum New Patient Copayment $13.47
Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $95.41
Minimum Established Patient Price $17.4
Maximum Established Patient Price $133.76

Average Established Patient Copayment $23.85
Minimum Established Patient Copayment $4.35
Maximum Established Patient Copayment $33.44

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

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Chronic Care and Preventative Care Management for Empaneled Patients	Yes	N/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Documentation of Current Medications in the Medical Record	100%	43
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing	96%	1016
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	72%	140
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 at least one transition of care or referral.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel Level	Yes	N/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation	100%	78
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.
Patient-Specific Education	89%	1467
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	29%	49
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Screening for Depression and Follow-Up Plan	73%	388
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Provide Patient Access	72%	1466
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 certain information.
Secure Messaging	8%	1466
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 message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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 1023002110, we treat the final digit (0) 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 40. The final step is to find the difference between that total and the next multiple of ten (40 - 40 = 0).

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.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 4

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 2

Check

Target digit

Regular digit Doubled digit Check digit

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.

1 → 2 2 → 4 0 → 0 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 4 + 3 + 0 + 0 + 4 + 1 + 2 + 24 = 40

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 40 is 40. The difference is the calculated check digit.

40 - 40 = 0

This NPI is valid

The calculated check digit is 0, which matches the last digit of 1023002110.