AHMED ISMAIL DO
Accepted Insurance for NPI 1346863321
Hospitalist in Summit, WI

Q: What managed care network types are accepted by this provider?

AHMED ISMAIL DO is enrolled across the following managed care network types: EPO, HMO, POS. HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.

NPI Status: Active since May 25, 2020

Contact Information

36500 AURORA DR
SUMMIT, WI
ZIP 53066
Phone: (262) 434-1000
Fax: (262) 434-1000

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with AHMED ISMAIL DO, a practicing hospitalist professional in Summit, WI. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 30 individual coverage options managed by medical networks, including networks like Aspirus Health Plan, and CareSource (Common Ground Healthcare). Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

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Aspirus Health Plan

HMO Bronze $0 Medical Deductible

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010016

HMO Bronze 10000

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010009

HMO Bronze 7500

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010011

HMO Catastrophic 10600 with 3 free PCP visits

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010008

HMO Gold 2000

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010015

HMO Gold 2700

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010007

HMO HDHP Silver 5900

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010013

HMO Silver 6000

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010012

HMO Silver 6600

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010001

POS Bronze 7500

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0020005

POS Bronze 8500

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0020003

POS Silver 6000

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0020001

CareSource (Common Ground Healthcare)

CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030003

CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060023

CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay)

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030027

CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060015

CareSource (Common Ground Healthcare) Bronze Standard $7500

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030041

CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060003

CareSource (Common Ground Healthcare) Gold $0 Ded

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030005

CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060025

CareSource (Common Ground Healthcare) Gold $3300

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030017

CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060006

CareSource (Common Ground Healthcare) Gold Standard $2000

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030043

CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060001

CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030023

CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060012

CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030047

CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060011

CareSource (Common Ground Healthcare) Silver Standard $6000

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030042

CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060002

No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

What insurance does AHMED ISMAIL DO accept?

This provider accepts health insurance plans managed by the following insurance companies: Aspirus Health Plan, CareSource (Common Ground Healthcare). You can filter specific policies or search for unique plans using the open dashboard controls located above.

Is this provider enrolled to accept Medicare?

Yes, registry files confirm this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. Additionally, the provider is officially enrolled in the PECOS program (Provider Enrollment, Chain, and Ownership System), verifying that they are certified to order, refer, or prescribe services to Medicare beneficiaries.

What managed care network types are accepted by this provider?

AHMED ISMAIL DO is enrolled across the following managed care network types: EPO, HMO, POS.

HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.
POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.