DR. MATTHEW S MARCUS M.D.
NPI 1316108475
Orthopaedic Surgery - Sports Medicine in Kenosha, WI

Q: What is Matthew Marcus's NPI number?

The NPI number for Matthew Marcus is 1316108475. It was assigned to this individual provider in the NPPES registry on June 21, 2008.

Q: What is Matthew Marcus's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Marcus was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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 21, 2008PECOS EnrolledAccepts Medicare Assignment

7401 104TH AVE STE 110, KENOSHA, WI 53142(262) 764-5595(262) 764-9314 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Matthew S Marcus M.d. NPPES

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

DR. MATTHEW S MARCUS M.D. (NPI 1316108475) is an individual sports medicine provider in Kenosha, Wisconsin, licensed in Illinois (036-132087) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and is a graduate of Other (2008).

NPPES Registry Identity

NPI1316108475

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameDR. MATTHEW S MARCUSCredential: M.D.

Location Address7401 104TH AVE STE 110Kenosha, WI 53142-7845

Mailing Address7401 104th Ave Ste 110Kenosha, WI 53142-7845 · (262) 764-5595 · Fax (262) 764-9314

Phone(262) 764-5595

Fax(262) 764-9314

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJune 21, 2008

Last NPPES UpdateJanuary 22, 2025

NPPES CertifiedJanuary 22, 2025

✔ NPI 1316108475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in IL · 036-132087

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

7401 104TH AVE STE 110, Kenosha, WI 53142

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, UnitedHealthcare.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. Matthew S Marcus M.d. 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 ID1557684958

PECOS Enrollment IDI20190103000792

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.

Medicare Billing Reassignment

Medicare enrollment records show Matthew Marcus reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Comprehensive Orthopaedics Sc

Same address

Orthopaedic Surgery

7401 104TH AVE, SUITE 110
Kenosha, WI 53142

Reassigned Medicare billing, Wisconsin enrollment
19 clinicians in this Medicare group

NPI 1295717445 (262) 764-5891

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 7

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

182 services36 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.

169 services108 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

43 services37 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

39 services35 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.

26 services26 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

21 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Aurora Medical Center Kenosha

Acute Care Hospitals · Kenosha, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520189

Location10400 75th StKenosha, WI 53142 · Kenosha County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 12

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

CLAY JAMISON FRANK M.D.

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)