DON E BRECKBILL MD
NPI 1295779064
Emergency Medicine in Madison, WI

Q: What is Don Breckbill's NPI number?

The NPI number for Don Breckbill is 1295779064. It was assigned to this individual provider in the NPPES registry on June 15, 2006.

Q: What is Don Breckbill's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Don Breckbill was last updated on November 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 June 15, 2006PECOS EnrolledAccepts Medicare Assignment

1821 S STOUGHTON RD, MADISON, WI 53716(608) 260-6000(608) 260-6161 Get Directions Write a Review

NPPES record last updated: November 4, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2020, Oct 24, 2019, Apr 9, 2018 and 1 more (4 updates tracked since 2018).

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About Don E Breckbill Md NPPES

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

DON E BRECKBILL MD (NPI 1295779064) is an individual emergency medicine provider in Madison, Wisconsin, licensed in Wisconsin (36168-20) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - Madison, and maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1295779064

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameDON E BRECKBILLCredential: MD

Location Address1821 S STOUGHTON RDMadison, WI 53716

Mailing Address1821 S Stoughton RdMadison, WI 53716-2257 · (608) 260-6000 · Fax (608) 260-6161

Phone(608) 260-6000

Fax(608) 260-6161

Sole ProprietorNo

Medical School CMSUniversity Of Virginia School Of MedicineGraduated 1993

Enumeration DateJune 15, 2006

Last NPPES UpdateNovember 4, 20204 updates tracked since enumeration

NPPES CertifiedNovember 4, 2020

✔ NPI 1295779064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in WI · 36168-20

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

1821 S STOUGHTON RD, Madison, WI 53716

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Secondary Practice Location 1

Location 11821 S Stoughton RdMadison, WI 53716 · Phone (608) 260-6000 · Fax (608) 260-6161

Other Identifiers 1

Medicaid1295779064WI

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

Don E Breckbill 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 ID9234269929

PECOS Enrollment IDI20100607000233

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 10

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 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.

105 services102 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

43 services43 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.

40 services40 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

38 services37 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

15 services15 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520083

Location700 South Park StMadison, WI 53715 · Dane County

Emergency services Birthing friendly

Ssm Health St Mary's Hospital - Janesville

Acute Care Hospitals · Janesville, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number520208

Location3400 East Racine StreetJanesville, WI 53546 · Rock County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53716 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.

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

50%107 patients3/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

88%131 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

19%178 patients1/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

71%75 patients3/55-star benchmark: 98%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

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