DR. THOMAS JOHN ZWEIFEL D.O.
NPI 1114027307
Psychiatry & Neurology - Neurology in Sheboygan, WI

Active since September 25, 2006PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
3113 SAEMANN AVE, SHEBOYGAN, WI 53081(920) 496-4700 Get Directions Write a Review

NPPES record last updated: August 26, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 26, 2020, Nov 8, 2019 (2 updates tracked since 2019).

About Dr. Thomas John Zweifel D.o. NPPES

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

DR. THOMAS JOHN ZWEIFEL D.O. (NPI 1114027307) is an individual neurology provider in Sheboygan, Wisconsin, licensed in Wisconsin (19643) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with St Nicholas Hospital, and maintains a secondary practice location in Sheboygan.

NPPES Registry Identity

NPI1114027307
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. THOMAS JOHN ZWEIFELCredential: D.O.
Location Address3113 SAEMANN AVESheboygan, WI 53081-1957
Mailing AddressPo Box 19070Green Bay, WI 54307-9070 · (920) 496-4700
Sole ProprietorYes
Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 1974
Enumeration DateSeptember 25, 2006
Last NPPES UpdateAugust 26, 20202 updates tracked since enumeration
NPPES CertifiedAugust 26, 2020
NPI 1114027307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License Licensed in WI · 19643
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
3113 SAEMANN AVE, Sheboygan, WI 53081

Secondary Practice Location 1

Location 11440 N 25TH STSHEBOYGAN, WI 53081-3108 · Phone (920) 457-3737 · Fax (920) 457-1012

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. Thomas John Zweifel D.o. 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 ID2961545058
PECOS Enrollment IDI20100212000011
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 12

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.

Injection, onabotulinumtoxina, 1 unit J0585
Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
8,290 services14 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.
105 services77 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.
69 services56 patients
Needle measurement of electrical activity in arm or leg muscles, complete study 95886
This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.
55 services52 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
44 services34 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
40 services40 patients

Hospital Affiliations CMS Care Compare 2

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

St Nicholas Hospital

Acute Care Hospitals · Sheboygan, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520044
Location3100 Superior AveSheboygan, WI 53081 · Sheboygan County
Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown 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.

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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

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.

Nurse Practitioner (Gerontology)
3113 SAEMANN AVE
SHEBOYGAN, WI 53081
Surgery
3113 SAEMANN AVE
SHEBOYGAN, WI 53081
Internal Medicine
3113 SAEMANN AVE
SHEBOYGAN, WI 53081
Ophthalmology
3113 SAEMANN AVE
SHEBOYGAN, WI 53081
Ophthalmology
3113 SAEMANN AVE
SHEBOYGAN, WI 53081
Durable Medical Equipment & Medical Supplies
3113 SAEMANN AVE
SHEBOYGAN, WI 53081
Physician Assistant
3113 SAEMANN AVE
SHEBOYGAN, WI 53081
Audiologist
3113 SAEMANN AVE
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 Thomas Zweifel's NPI number?

The NPI number for Thomas Zweifel is 1114027307. It was assigned to this individual provider in the NPPES registry on September 25, 2006.

Where is Thomas Zweifel located?

Thomas Zweifel practices at 3113 Saemann Ave, Sheboygan, WI 53081. The listed phone number is (920) 496-4700.

What is Thomas Zweifel's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Thomas Zweifel enrolled in Medicare?

Yes. Thomas Zweifel 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 Thomas Zweifel accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and Security Health Plan list Thomas Zweifel 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 Thomas Zweifel affiliated with any hospitals?

According to CMS data, Thomas Zweifel is affiliated with St Nicholas Hospital and St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Zweifel was last updated on August 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.