JONATHAN RATHOD MD
NPI 1174987267
Internal Medicine - Pulmonary Disease in Mount Pleasant, WI

Q: What is Jonathan Rathod's NPI number?

The NPI number for Jonathan Rathod is 1174987267. It was assigned to this individual provider in the NPPES registry on April 5, 2016.

Q: What is Jonathan Rathod's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Rathod was last updated on March 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 05, 2016PECOS EnrolledAccepts Medicare Assignment

82.39/100

CMS Quality Rating

3803 SPRING ST, MOUNT PLEASANT, WI 53405(262) 687-5236 Get Directions Write a Review

NPPES record last updated: March 27, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 13, 2022, Oct 9, 2018 (2 updates tracked since 2018).

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About Jonathan Rathod Md NPPES

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

JONATHAN RATHOD MD (NPI 1174987267) is an individual pulmonary disease provider in Mount Pleasant, Wisconsin, licensed in Wisconsin (69453) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with St. Agnes Hospital Hospice, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1174987267

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameJONATHAN RATHODCredential: MD

Location Address3803 SPRING STMount Pleasant, WI 53405-1660

Mailing Address3803 Spring StMount Pleasant, WI 53405-1660 · (262) 687-5236

Phone(262) 687-5236

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateApril 5, 2016

Last NPPES UpdateMarch 27, 20242 updates tracked since enumeration

NPPES CertifiedMarch 27, 2024

✔ NPI 1174987267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in WI · 69453

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 69453 (WI)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3803 SPRING ST, Mount Pleasant, WI 53405

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Accepted Insurance

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

Jonathan Rathod 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 ID7618209123

PECOS Enrollment IDI20220927002342

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 9

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.

58 services52 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.

47 services43 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

37 services37 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

35 services35 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

34 services34 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

33 services19 patients

Hospital Affiliations CMS Care Compare 3

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

St. Agnes Hospital Hospice

Acute Care Hospitals · Fond Du Lac, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520088

Location430 E Division StFond Du Lac, WI 54935 · Fond Du Lac County

Emergency services Birthing friendly

Ripon Medical Center

Critical Access Hospitals · Ripon, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521321

Location845 Parkside StRipon, WI 54971 · Fond Du Lac County

Emergency services

Waupun Memorial Hospital

Critical Access Hospitals · Waupun, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521327

Location620 W Brown StWaupun, WI 53963 · Fond Du Lac County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53405 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.

82.39/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

77.88

Promoting Interoperability

Improvement Activities

Cost

74.38

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.

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

2 suppliers20 claims20 services$84.10 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.

ALEK ZAPATA PA-C

Physician Assistant

3803 SPRING ST
MOUNT PLEASANT, WI 53405

Racine County (262) 687-4011

REBECCA EDWARDS

Physician Assistant

3803 SPRING ST
MOUNT PLEASANT, WI 53405

Racine County (262) 687-4011

EKI DRAKE FNP

Nurse Practitioner (Adult Health)

3803 SPRING ST
MOUNT PLEASANT, WI 53405

Racine County (262) 687-4011

BILLIE A LAWLER APNP

Nurse Practitioner (Acute Care)

3803 SPRING ST
MOUNT PLEASANT, WI 53405

Racine County (262) 687-6260

HOWARD W. SHORT M.D.

Internal Medicine (Cardiovascular Disease)

3803 SPRING ST, SUITE 410
RACINE, WI 53405

Racine County (262) 687-8260

KATELYN CURTIS PA-C

Physician Assistant

3803 SPRING ST
RACINE, WI 53405

Racine County (262) 687-4011

STEVEN ARTHUR SPRING RPH

Pharmacist

3803 SPRING ST
MOUNT PLEASANT, WI 53405

Racine County (262) 687-4308

GHAITH ALMHANNI MD

Student in an Organized Health Care Education/Training Program

3803 SPRING ST
MOUNT PLEASANT, WI 53405

Racine County (126) 268-7401

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 Jonathan Rathod's NPI number?

The NPI number for Jonathan Rathod is 1174987267. It was assigned to this individual provider in the NPPES registry on April 5, 2016.

Where is Jonathan Rathod located?

Jonathan Rathod practices at 3803 Spring St, Mount Pleasant, WI 53405. The listed phone number is (262) 687-5236.

What is Jonathan Rathod's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Jonathan Rathod enrolled in Medicare?

Yes. Jonathan Rathod 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 Jonathan Rathod accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and Quartz list Jonathan Rathod 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 Jonathan Rathod affiliated with any hospitals?

According to CMS data, Jonathan Rathod is affiliated with St. Agnes Hospital Hospice, Ripon Medical Center and Waupun Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Jonathan Rathod was last updated on March 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.