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ADAM R COUGHLIN M.D.
NPI 1164865382
Otolaryngology in Madison, WI

Active since April 08, 2013PECOS EnrolledAccepts Medicare Assignment
752 N HIGH POINT RD, MADISON, WI 53717(608) 824-4000(608) 824-4910 Get Directions Write a Review

NPPES record last updated: November 6, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 6, 2020, Aug 7, 2018, Jan 2, 2017 (3 updates tracked since 2017).

About Adam R Coughlin M.d. NPPES

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

ADAM R COUGHLIN M.D. (NPI 1164865382) is an individual otolaryngology provider in Madison, Wisconsin, licensed in Wisconsin (62997) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - Madison, and maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1164865382
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameADAM R COUGHLINCredential: M.D.
Location Address752 N HIGH POINT RDMadison, WI 53717-2236
Mailing Address752 N High Point RdMadison, WI 53717-2236 · (608) 824-4000 · Fax (608) 824-4868
Phone(608) 824-4000
Fax(608) 824-4910
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateApril 8, 2013
Last NPPES UpdateNovember 6, 20203 updates tracked since enumeration
NPPES CertifiedNovember 6, 2020
✔ NPI 1164865382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in WI · 62997
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
752 N HIGH POINT RD, Madison, WI 53717
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Secondary Practice Location 1

Location 1Uw Hospital and Clinics, 600 Highland Ave., H4/831Madison, WI 53792-0001 · Phone (608) 263-0192

Other Identifiers 1

Medicaid1164865382WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Adam R Coughlin 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 ID4082910674
PECOS Enrollment IDI20180823001331
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.

Medicare Billing Reassignment

Medicare enrollment records show Adam Coughlin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dean Health Systems, Inc
6.3 mi
Allergy & Immunology
1211 FISH HATCHERY RD
Madison, WI 53715
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,377 clinicians in this Medicare group
NPI 1053358846 (608) 252-8000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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 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.
68 services60 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
63 services63 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.
63 services53 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
59 services52 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
59 services59 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
35 services30 patients

Hospital Affiliations CMS Care Compare 2

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

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520083
Location700 South Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

Upland Hills Health

Critical Access Hospitals · Dodgeville, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521352
Location800 Compassion WayDodgeville, WI 53533 · Iowa County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53717 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
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

HEATHER L MUCKLER COTA
Occupational Therapy Assistant
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4821
DR. MINDY BAUER PHARMD
Pharmacist
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4500
DAVID K FALK MD
Dermatology
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DAVID A SORBER MD
Internal Medicine
752 N HIGH POINT RD, DEAN MEDICAL CENTER
MADISON, WI 53717
Dane County (608) 824-4800
JULIA L. THORSEN M.D.
Allergy & Immunology
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
SARAH A OLIVER PA-C
Physician Assistant
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DR. GRANT MACAULAY M.D.
Internal Medicine
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DR. JUI B HAKER MD
Preventive Medicine (Occupational Medicine)
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000

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 Adam Coughlin's NPI number?

The NPI number for Adam Coughlin is 1164865382. It was assigned to this individual provider in the NPPES registry on April 8, 2013.

Where is Adam Coughlin located?

Adam Coughlin practices at 752 N High Point Rd, Madison, WI 53717. The listed phone number is (608) 824-4000.

What is Adam Coughlin's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Adam Coughlin enrolled in Medicare?

Yes. Adam Coughlin 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.

Which organization bills Medicare for Adam Coughlin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adam Coughlin reassigns Medicare benefits to Dean Health Systems, Inc (Madison, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Adam Coughlin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Adam Coughlin accept?

Health plans from Anthem Blue Cross and Blue Shield and Dean Health Plan list Adam Coughlin 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 Adam Coughlin affiliated with any hospitals?

According to CMS data, Adam Coughlin is affiliated with Ssm Health St Mary's Hospital - Madison and Upland Hills Health.

When was this NPI record last updated?

The NPPES record for Adam Coughlin was last updated on November 6, 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.