DR. GEORGE T POULLETTE MD
NPI 1104933415
Family Medicine in Pleasant Prairie, WI

Active since August 23, 2006PECOS EnrolledAccepts Medicare Assignment
79.61/100
CMS Quality Rating
10256 OLD GREEN BAY ROAD, PLEASANT PRAIRIE, WI 53158(262) 551-4200(262) 551-4947 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Mar 7, 2023, Aug 9, 2019, Jan 15, 2018 and 2 more (5 updates tracked since 2017).

About Dr. George T Poullette Md NPPES

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

DR. GEORGE T POULLETTE MD (NPI 1104933415) is an individual family medicine provider in Pleasant Prairie, Wisconsin, licensed in Wisconsin (30486) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and is a graduate of University Of Wisconsin School Of Medicine (1988).

NPPES Registry Identity

NPI1104933415
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. GEORGE T POULLETTECredential: MD
Location Address10256 OLD GREEN BAY ROADPleasant Prairie, WI 53158-2815
Mailing Address6308 8th AveKenosha, WI 53143-5031 · (262) 577-8320 · Fax (262) 577-8321
Fax(262) 551-4947
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1988
Enumeration DateAugust 23, 2006
Last NPPES UpdateMarch 7, 20235 updates tracked since enumeration
NPI 1104933415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in WI · 30486
Definition
Family 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.
10256 OLD GREEN BAY ROAD, Pleasant Prairie, WI 53158

Other Identifiers 1

Other30486-20WI · Wi License

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. George T Poullette 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.

PECOS PAC ID7810928587
PECOS Enrollment IDI20050823000803
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 17

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.
444 services266 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.
321 services217 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
275 services90 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
153 services64 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.
143 services143 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
109 services86 patients

Hospital Affiliations CMS Care Compare

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

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI
1/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number520021
Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53158 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
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.

79.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.88
Promoting Interoperability100
Improvement Activities40
Cost61.15

Referred Medical Equipment & Supplies CMS DME claims 8

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
20 suppliers72 claims217 services$5.08 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
14 suppliers40 claims61 services$0.90 avg. paid by Medicare
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each A4419
DME-Orthotic Devices · category DF010N
1 supplier11 claims660 services$1.51 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers48 claims48 services$14.50 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers59 claims59 services$68.54 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
2 suppliers13 claims13 services$6.63 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 George Poullette's NPI number?

The NPI number for George Poullette is 1104933415. It was assigned to this individual provider in the NPPES registry on August 23, 2006.

Where is George Poullette located?

George Poullette practices at 10256 Old Green Bay Road, Pleasant Prairie, WI 53158. The listed phone number is (262) 551-4200.

What is George Poullette's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is George Poullette enrolled in Medicare?

Yes. George Poullette 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 George Poullette accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Anthem Blue Cross and Blue Shield and Network Health list George Poullette 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 George Poullette affiliated with any hospitals?

According to CMS data, George Poullette is affiliated with Froedtert South Inc..

When was this NPI record last updated?

The NPPES record for George Poullette was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.