DR. TODD GOULD MD
NPI 1265431126
Ophthalmology in Green Bay, WI
About Dr. Todd Gould Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. TODD GOULD MD (NPI 1265431126) is an individual ophthalmology provider in Green Bay, Wisconsin, licensed in Wisconsin (53432-020) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital Medical Center, and is a graduate of University Of Wisconsin School Of Medicine (1992).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 10
Accepted 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
Dr. Todd Gould 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.
Medicare Billing Reassignments
3Medicare enrollment records show Todd Gould reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Green Bay, WI 54301
- Reassigned Medicare billing, Wisconsin enrollment
- 216 clinicians in this Medicare group
Green Bay, WI 54304
- Reassigned Medicare billing, Wisconsin enrollment
- 742 clinicians in this Medicare group
Sheboygan, WI 53081
- Reassigned Medicare billing, Wisconsin enrollment
- 673 clinicians in this Medicare group
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 11
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Mary's Hospital Medical Center
Acute Care Hospitals · Green Bay, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
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.
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 Todd Gould's NPI number?
The NPI number for Todd Gould is 1265431126. It was assigned to this individual provider in the NPPES registry on July 21, 2005.
Where is Todd Gould located?
Todd Gould practices at 1821 S Webster Ave, Green Bay, WI 54301. The listed phone number is (920) 496-4700.
What is Todd Gould's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Todd Gould enrolled in Medicare?
Yes. Todd Gould 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 organizations bill Medicare for Todd Gould's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Todd Gould reassigns Medicare benefits to 3 organizations: St. Clare Memorial Hospital, Inc. (Green Bay, WI), St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (Green Bay, WI) and St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (Sheboygan, WI). Each 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 Todd Gould's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Todd Gould accept?
Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, Network Health and Security Health Plan list Todd Gould 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 Todd Gould affiliated with any hospitals?
According to CMS data, Todd Gould is affiliated with St Mary's Hospital Medical Center.
When was this NPI record last updated?
The NPPES record for Todd Gould was last updated on November 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Dr. Todd Gould, MD · NPI 1265431126
Ophthalmology physician in Green Bay, Wisconsin. Individual provider, active in the CMS NPPES registry since July 21, 2005.
## Identity
- **NPI:** 1265431126 (Entity type: Individual)
- **Enumerated:** July 21, 2005
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **State license:** 53432-020 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 1821 S WEBSTER AVE, Green Bay, WI 54301-2253
- **Phone:** (920) 496-4700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): St. Clare Memorial Hospital, Inc. (NPI 1093173791, Green Bay, WI); St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (NPI 1285613638, Green Bay, WI); St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (NPI 1275799413, Sheboygan, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Wisconsin School Of Medicine, class of 1992
## Record status
- **NPPES last updated:** November 22, 2016
- **Other identifiers:** Other 0800753; Other 150957CR; Other 180028986 (OH); and 7 more
---
Source: [NPI Profile](https://npiprofile.com/npi/1265431126) · Data from the CMS NPPES public registry.