JAMES THOMAS BERNATZ M.D.
NPI 1194250167
Orthopaedic Surgery in Madison, WI

Q: What is James Bernatz's NPI number?

The NPI number for James Bernatz is 1194250167. It was assigned to this individual provider in the NPPES registry on April 26, 2017.

Q: What is James Bernatz's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for James Bernatz was last updated on August 8, 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.

Active since April 26, 2017PECOS EnrolledAccepts Medicare Assignment

4602 EASTPARK BLVD, MADISON, WI 53718(608) 265-3207(608) 662-4545 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 8, 2023, Dec 7, 2022, Apr 26, 2017 (3 updates tracked since 2017).

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About James Thomas Bernatz M.d. NPPES

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

JAMES THOMAS BERNATZ M.D. (NPI 1194250167) is an individual orthopaedic surgery provider in Madison, Wisconsin, licensed in Wisconsin (70296-20) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Meriter, and is a graduate of University Of Wisconsin School Of Medicine (2017).

NPPES Registry Identity

NPI1194250167

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameJAMES THOMAS BERNATZCredential: M.D.

Location Address4602 EASTPARK BLVDMadison, WI 53718-2002

Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531

Phone(608) 265-3207

Fax(608) 662-4545

Sole ProprietorNo

Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2017

Enumeration DateApril 26, 2017

Last NPPES UpdateAugust 8, 20233 updates tracked since enumeration

NPPES CertifiedAugust 8, 2023

✔ NPI 1194250167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in WI · 70296-20

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

4602 EASTPARK BLVD, Madison, WI 53718

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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, Aspirus Health Plan, Group Health Cooperative-SCW and more.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

James Thomas Bernatz 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 ID6406126499

PECOS Enrollment IDI20230809003425

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 16

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.

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

33 services24 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.

31 services22 patients

Computer-assisted spinal procedure 61783

A computer-assisted spinal procedure is a surgical technique that uses computer technology for improved precision. It involves creating a 3D image of your spine to guide the surgeon during the operation. This method enhances accuracy, reduces risk, and promotes quicker recovery.

29 services28 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

26 services26 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.

25 services24 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.

22 services19 patients

Fusion of spine in lower back 22612

Fusion of the spine in the lower back, also known as lumbar spinal fusion, is a surgery aimed to join, or fuse, two or more vertebrae in your lower back. This procedure can help alleviate pain and improve stability by reducing movement between the vertebrae.

16 services16 patients

Placement of stabilizing device to back of 1 spine bone in neck 22840

This procedure involves positioning a stabilizing device onto a single spinal bone in the neck. The goal is to provide support and prevent movement that could cause discomfort or further injury. It's performed by trained specialists under anesthesia.

16 services16 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.

16 services16 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

16 services12 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.

15 services15 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

15 services15 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

13 services11 patients

Fusion of lower spine bone through abdomen with partial removal of disc 22558

This procedure involves merging the bones in your lower spine through an abdominal approach. A portion of the disc, which acts like a cushion between your vertebrae, is partially removed. The goal is to alleviate back pain by limiting movement in the problem area of your spine.

12 services12 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

12 services12 patients

Placement of stabilizing device to back, 3-6 spine bone segments 22842

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520089

Location202 S Park StMadison, WI 53715 · Dane County

Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number520098

Location600 Highland AvenueMadison, WI 53792 · Dane County

Emergency services

Mile Bluff Medical Center

Acute Care Hospitals · Mauston, WI

OwnershipProprietary

CMS Certification Number520109

Location1050 Division StMauston, WI 53948 · Juneau County

Emergency services Birthing friendly

Richland Hospital

Critical Access Hospitals · Richland Center, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521341

Location333 E Second StRichland Center, WI 53581 · Richland County

Emergency services

Stoughton Hospital

Critical Access Hospitals · Stoughton, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521343

Location900 Ridge StStoughton, WI 53589 · Dane County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53718 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

$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.

ERIKA A FEHRENBACH PRELL NP

Nurse Practitioner