THERESA MAATMAN
NPI 1043509540
Internal Medicine in Milwaukee, WI

Active since April 05, 2011PECOS EnrolledAccepts Medicare Assignment
80.46/100
CMS Quality Rating
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE, MILWAUKEE, WI 53226(414) 805-6850(414) 805-6851 Get Directions Write a Review

NPPES record last updated: September 11, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Theresa Maatman NPPES

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

THERESA MAATMAN (NPI 1043509540) is an individual internal medicine provider in Milwaukee, Wisconsin, licensed in Wisconsin (60284) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS, is affiliated with Froedtert Memorial Lutheran Hospital, and is a graduate of Medical College Of Wisconsin (2011).

NPPES Registry Identity

NPI1043509540
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameTHERESA MAATMAN
Location Address9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINEMilwaukee, WI 53226-3522
Mailing Address9200 W Wisconsin Ave, Dept Of Internal MedicineMilwaukee, WI 53226-3522 · (414) 805-6850 · Fax (414) 805-6851
Fax(414) 805-6851
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 2011
Enumeration DateApril 5, 2011
Last NPPES UpdateSeptember 11, 2014
NPI 1043509540 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in WI · 60284
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

9200 W WISCONSIN AVE, Milwaukee, WI 53226

Other Identifiers 2

Medicare PINK400139362WI
Medicaid1043509540WI

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

Theresa Maatman 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 ID1456574805
PECOS Enrollment IDI20140603002044
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 3

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.

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.
81 services61 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
26 services26 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
14 services12 patients

Hospital Affiliations CMS Care Compare

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

Froedtert Memorial Lutheran Hospital

Acute Care Hospitals · Milwaukee, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520177
Location9200 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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.

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.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.24
Promoting Interoperability100
Improvement Activities40
Cost68.64

Referred Medical Equipment & Supplies CMS DME claims

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers24 claims51 services$5.56 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.

Advanced Practice Midwife
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Internal Medicine (Gastroenterology)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Emergency Medicine
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Nurse Practitioner (Pediatrics)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE
MILWAUKEE, WI 53226
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Nurse Anesthetist, Certified Registered
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Physician Assistant (Medical)
9200 W WISCONSIN AVE, INTERNAL MEDICINE
MILWAUKEE, WI 53226

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 Theresa Maatman's NPI number?

The NPI number for Theresa Maatman is 1043509540. It was assigned to this individual provider in the NPPES registry on April 5, 2011.

Where is Theresa Maatman located?

Theresa Maatman practices at 9200 W Wisconsin Ave Dept Of Internal Medicine, Milwaukee, WI 53226. The listed phone number is (414) 805-6850.

What is Theresa Maatman's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Theresa Maatman enrolled in Medicare?

Yes. Theresa Maatman 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 Theresa Maatman accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan and Network Health list Theresa Maatman 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 Theresa Maatman affiliated with any hospitals?

According to CMS data, Theresa Maatman is affiliated with Froedtert Memorial Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Theresa Maatman was last updated on September 11, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.