RAHUL VERMA M.D.
NPI 1225085582
Internal Medicine - Cardiovascular Disease in Green Bay, WI

NPI Status: Active since May 30, 2006

Contact Information

744 S WEBSTER AVE
2ND FLOOR
GREEN BAY, WI
ZIP 54301
Phone: (920) 433-3640
Fax: (922) 433-3716

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  • Individual
  • Male
  • Years of Experience 38
  • Internal Medicine
  • Cardiovascular Disease
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About RAHUL VERMA

This page provides the complete NPI Profile along with additional information for Rahul Verma, an internist established in Green Bay, Wisconsin with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 38 years of experience. The healthcare provider is registered in the NPI registry with number 1225085582 assigned on May 2006. The practitioner's primary taxonomy code is 207RC0000X with license number 44438-20 (WI). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1225085582
Provider Name
RAHUL VERMA M.D.
Gender
Male
Entity Type
Individual
Location Address
744 S WEBSTER AVE 2ND FLOOR GREEN BAY, WI 54301
Location Phone
(920) 433-3640
Location Fax
(922) 433-3716
Mailing Address
PO BOX 22487 GREEN BAY, WI 54305
Mailing Phone
(920) 445-7222
Mailing Fax
(922) 433-3716
Medical School Name
OTHER
Graduation Year
1988
Is Sole Proprietor?
No
Enumeration Date
05-30-2006
Last Update Date
12-11-2020
Code Navigator

An internist like Rahul Verma is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Cardiovascular Disease

Taxonomy Code
207RC0000X
Type
Allopathic & Osteopathic Physicians
License No.
44438-20
License State
WI
Taxonomy Description
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • HMO Bronze $0 Medical Deductible - HMO
  • HMO Bronze 10000 - HMO
  • HMO Bronze 7500 - HMO
  • HMO Catastrophic 10600 with 3 free PCP visits - HMO
  • HMO Gold 2000 - HMO
  • HMO Gold 2700 - HMO
  • HMO HDHP Silver 5900 - HMO
  • HMO Silver 6000 - HMO
  • HMO Silver 6600 - HMO
  • POS Bronze 7500 - POS
  • Blue Cross� Preferred HMO Bronze Extra - HMO
  • Blue Cross� Preferred HMO Bronze Saver HSA - HMO
  • Blue Cross� Preferred HMO Bronze Secure - HMO
  • Blue Cross� Preferred HMO Gold - HMO
  • Blue Cross� Preferred HMO Gold Extra - HMO
  • Blue Cross� Preferred HMO Silver - HMO
  • Blue Cross� Preferred HMO Silver Extra - HMO
  • Blue Cross� Preferred HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Value - HMO
  • Blue Cross� Select HMO Bronze Extra - HMO
  • Blue Cross� Premier PPO Bronze Extra - PPO
  • Blue Cross� Premier PPO Bronze Saver HSA - PPO
  • Blue Cross� Premier PPO Bronze Secure - PPO
  • Blue Cross� Premier PPO Gold - PPO
  • Blue Cross� Premier PPO Gold Extra - PPO
  • Blue Cross� Premier PPO Silver - PPO
  • Blue Cross� Premier PPO Silver Extra - PPO
  • Blue Cross� Premier PPO Silver Saver HSA - PPO
  • Blue Cross� Premier PPO Value - PPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • NE WI Select $3,150 Plus Silver - PPO
  • NE WI Select $3,800 HSA Silver - PPO
  • NE WI Select $6,000 Standard Silver - PPO
  • NE WI Select $6,800 Plus Bronze HSA - PPO
  • NE WI Select $7,500 Standard Bronze HSA - PPO
  • NE WI Select $8,400 HSA Bronze - PPO
  • Oak $1,300 Gold - PPO
  • Oak $2,000 Standard Gold - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
34269800MEDICAID (05)WI 
44438-20OTHER (01)WIWISCONSIN LICENSE
4301091396OTHER (01)MIMICHIGAN LICENSE

Medicare Participation & PECOS Enrollment Status

Rahul Verma is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Rahul Verma is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2567352461

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040316000741, I20080314000093

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 40 times for 37 patients

Established patient office or other outpatient visit, 40-54 minutes

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.

This service was performed 14 times for 14 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

This service was performed 94 times for 94 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

This service was performed 62 times for 62 patients

External shock to heart to regulate heart beat

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

This service was performed 16 times for 14 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 30 times for 19 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 17 times for 13 patients

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days

This procedure involves wearing a device, an external EKG, for up to 7 days to continuously monitor your heart rhythm. It helps detect irregularities that may not occur during a standard EKG. The device is non-invasive and safe.

This service was performed 12 times for 12 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

This service was performed 88 times for 88 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 1,985 times for 1,332 patients

Ultrasound of heart blood flow, valves and chambers

An ultrasound of your heart, also known as an echocardiogram, is a test that uses sound waves to create detailed images of your heart. It helps doctors check the health of your heart's chambers, valves, and blood flow.

This service was performed 12 times for 12 patients

Ultrasound of heart blood flow, valves and chambers, follow-up

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

This service was performed 48 times for 46 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

This service was performed 64 times for 60 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 394 times for 389 patients

Ultrasound of heart with probe in esophagus, with report

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

This service was performed 18 times for 18 patients

Ultrasound of heart, follow-up

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

This service was performed 80 times for 77 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $30.92 for a new patient copayment and $16.84 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 54301 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $123.69
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $30.92
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.37
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $16.84
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Rahul Verma is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
OSF ST FRANCIS HOSPITAL AND MEDICAL GROUP3401 LUDINGTON ST
ESCANABA, MI 49829
(906) 786-3311Critical Access Hospitals
BELLIN MEMORIAL HOSPITAL744 S WEBSTER AVE
GREEN BAY, WI 54305
(920) 433-3500Acute Care Hospitals
DOOR COUNTY MEDICAL CENTER323 SOUTH 18TH AVENUE
STURGEON BAY, WI 54235
(920) 743-5566Critical Access Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1225085582, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
2
Doubled → 4
Pos 4
5
Unchanged
Pos 5
0
Doubled → 0
Pos 6
8
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
5
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 5 → 10 → 1 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 4 + 5 + 0 + 8 + 1 + 0 + 5 + 1 + 6 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1225085582.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Anesthesiology
744 S WEBSTER AVE
GREEN BAY, WI 54301
Anesthesiology
744 S WEBSTER AVE
GREEN BAY, WI 54301
Emergency Medicine
744 S WEBSTER AVE
GREEN BAY, WI 54301
Anesthesiology
744 S WEBSTER AVE
GREEN BAY, WI 54301
Emergency Medicine
744 S WEBSTER AVE
GREEN BAY, WI 54301
Emergency Medicine
744 S WEBSTER AVE
GREEN BAY, WI 54301
Emergency Medicine
744 S WEBSTER AVE
GREEN BAY, WI 54301
Anesthesiology
744 S WEBSTER AVE
GREEN BAY, WI 54301
Anesthesiology
744 S WEBSTER AVE
GREEN BAY, WI 54301
Anesthesiology
744 S WEBSTER AVE
GREEN BAY, WI 54301
Anesthesiology
744 S WEBSTER AVE
GREEN BAY, WI 54301
Physician Assistant
744 S WEBSTER AVE
GREEN BAY, WI 54301
Dietitian, Registered
744 S WEBSTER AVE
GREEN BAY, WI 54301
Internal Medicine
744 S WEBSTER AVE
GREEN BAY, WI 54301
Emergency Medicine
744 S WEBSTER AVE
GREEN BAY, WI 54301
Pathology (Anatomic Pathology & Clinical Pathology)
744 S WEBSTER AVE
GREEN BAY, WI 54301
Internal Medicine (Cardiovascular Disease)
744 S WEBSTER AVE
GREEN BAY, WI 54301
Pathology (Anatomic Pathology & Clinical Pathology)
744 S WEBSTER AVE
GREEN BAY, WI 54301
Pathology (Anatomic Pathology & Clinical Pathology)
744 S WEBSTER AVE
GREEN BAY, WI 54301
Pathology (Anatomic Pathology & Clinical Pathology)
744 S WEBSTER AVE
GREEN BAY, WI 54301

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1225085582, enumerated as an "individual" on May 30, 2006.

The provider is located at 744 S WEBSTER AVE 2ND FLOOR GREEN BAY, WI 54301 and the phone number is (920) 433-3640.

Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to verify.

Rahul Verma is affiliated with: OSF ST FRANCIS HOSPITAL AND MEDICAL GROUP, BELLIN MEMORIAL HOSPITAL and DOOR COUNTY MEDICAL CENTER.