MARLON J NAVARRO MD
NPI 1295822948
Internal Medicine - Rheumatology in Eau Claire, WI

Q: What is Marlon Navarro's NPI number?

The NPI number for Marlon Navarro is 1295822948. It was assigned to this individual provider in the NPPES registry on October 6, 2006.

Q: What is Marlon Navarro's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Q: When was this NPI record last updated?

The NPPES record for Marlon Navarro was last updated on November 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 October 06, 2006PECOS EnrolledAccepts Medicare Assignment

82.36/100

CMS Quality Rating

2116 CRAIG RD, EAU CLAIRE, WI 54701(715) 858-4538 Get Directions Write a Review

NPPES record last updated: November 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Marlon J Navarro Md NPPES

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

MARLON J NAVARRO MD (NPI 1295822948) is an individual rheumatology provider in Eau Claire, Wisconsin, licensed in Wisconsin (43188) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Marshfield Medical Center - Rice Lake, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1996).

NPPES Registry Identity

NPI1295822948

Entity TypeIndividualMale

Primary Taxonomy207RR0500X

Provider Legal NameMARLON J NAVARROCredential: MD

Location Address2116 CRAIG RDEau Claire, WI 54701-6149

Mailing Address1000 N Oak AveMarshfield, WI 54449-5703 · (715) 387-5511

Phone(715) 858-4538

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1996

Enumeration DateOctober 6, 2006

Last NPPES UpdateNovember 21, 2023

NPPES CertifiedNovember 21, 2023

✔ NPI 1295822948 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians

Taxonomy Code207RR0500X

License✔ Licensed in WI · 43188

Definition

An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

Also ListedInternal MedicineTaxonomy 207R00000X · License 43188 (WI)

2116 CRAIG RD, Eau Claire, WI 54701

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Other Identifiers 1

Medicaid34079400WI

Accepted Insurance

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

Marlon J Navarro 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 ID3173654787

PECOS Enrollment IDI20100625000674

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 8

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.

240 services179 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.

216 services171 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

182 services115 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.

120 services120 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

46 services37 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.

29 services25 patients

Hospital Affiliations CMS Care Compare 5

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

Marshfield Medical Center - Rice Lake

Acute Care Hospitals · Rice Lake, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520011

Location1700 West Stout StreetRice Lake, WI 54868 · Barron County

Emergency services Birthing friendly

Marshfield Medical Center

Acute Care Hospitals · Marshfield, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520037

Location611 St Joseph AveMarshfield, WI 54449 · Wood County

Emergency services Birthing friendly

Mayo Clinic Health System Eau Claire Hospital

Acute Care Hospitals · Eau Claire, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520070

Location1221 Whipple StEau Claire, WI 54703 · Eau Claire County

Emergency services Birthing friendly

Marshfield Medical Center - Eau Claire

Acute Care Hospitals · Eau Claire, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520210

Location2310 Craig RdEau Claire, WI 54701 · Eau Claire County

Emergency services Birthing friendly

Marshfield Medical Center - Ladysmith

Critical Access Hospitals · Ladysmith, WI

OwnershipGovernment - Hospital District or Authority

CMS Certification Number521328

Location1200 Port Arthur RdLadysmith, WI 54848 · Rusk County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54701 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

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.

82.36/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

76.38

Promoting Interoperability

100

Improvement Activities

Cost

50.29

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.

ANNA MARIE BYRNE DPT

Physical Therapist