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DANIEL P DUFFY MD
NPI 1235191511
Family Medicine in Cedarburg, WI

Active since April 04, 2006PECOS EnrolledAccepts Medicare Assignment
75.75/100
CMS Quality Rating
W62 N179 WASHINGTON AVE, CEDARBURG, WI 53012(262) 375-3555(262) 376-0275 Get Directions Write a Review

NPPES record last updated: June 12, 2012. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Daniel P Duffy Md NPPES

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

DANIEL P DUFFY MD (NPI 1235191511) is an individual family medicine provider in Cedarburg, Wisconsin, licensed in Wisconsin (29425) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, and is a graduate of Medical College Of Wisconsin (1987).

NPPES Registry Identity

NPI1235191511
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDANIEL P DUFFYCredential: MD
Location AddressW62 N179 WASHINGTON AVECedarburg, WI 53012
Mailing Address4425 N Port Washington Rd, Attn: Csmcp Clinic CredentialingGlendale, WI 53212-1082 · (262) 375-3555 · Fax (262) 376-0275
Phone(262) 375-3555
Fax(262) 376-0275
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 1987
Enumeration DateApril 4, 2006
Last NPPES UpdateJune 12, 2012
✔ NPI 1235191511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 29425
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
W62 N179 WASHINGTON AVE, Cedarburg, WI 53012
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Other Identifiers 3

Medicare UPINE47581
Medicare ID-Type Unspecified46280WI
Medicaid31548300WI

Accepted Insurance

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

Daniel P Duffy 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 ID6709894678
PECOS Enrollment IDI20070313000386
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 6

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.
379 services192 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
153 services153 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.
55 services49 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
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402
An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.
15 services15 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
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.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Ascension Columbia St Mary's Hospital Milwaukee

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520051
Location2323 N Lake DrMilwaukee, WI 53211 · Milwaukee County
Emergency services Birthing friendly

Ascension SE Wisconsin Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520136
Location5000 W Chambers StMilwaukee, WI 53210 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53012 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
$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.

75.75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.16
Promoting Interoperability76
Improvement Activities40
Cost57.63

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

M ORTHO, SC
Orthopaedic Surgery
W62 N179 WASHINGTON AVE, SUITE 3
CEDARBURG, WI 53012
Ozaukee County (262) 641-3700

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 Daniel Duffy's NPI number?

The NPI number for Daniel Duffy is 1235191511. It was assigned to this individual provider in the NPPES registry on April 4, 2006.

Where is Daniel Duffy located?

Daniel Duffy practices at W62 N179 Washington Ave, Cedarburg, WI 53012. The listed phone number is (262) 375-3555.

What is Daniel Duffy's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Daniel Duffy enrolled in Medicare?

Yes. Daniel Duffy 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 Daniel Duffy accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Daniel Duffy 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 Daniel Duffy affiliated with any hospitals?

According to CMS data, Daniel Duffy is affiliated with Ascension Columbia St Mary's Hospital Milwaukee and Ascension SE Wisconsin Hospital.

When was this NPI record last updated?

The NPPES record for Daniel Duffy was last updated on June 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.