STEPHEN M BOORSTEIN MD
NPI 1528009644
Ophthalmology in Madison, WI

Q: What is Stephen Boorstein's NPI number?

The NPI number for Stephen Boorstein is 1528009644. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Q: What is Stephen Boorstein's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Stephen Boorstein was last updated on November 3, 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 09, 2006PECOS EnrolledAccepts Medicare Assignment

752 N HIGH POINT RD, MADISON, WI 53717(608) 824-4800(608) 824-4910 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Stephen M Boorstein Md NPPES

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

STEPHEN M BOORSTEIN MD (NPI 1528009644) is an individual ophthalmology provider in Madison, Wisconsin, licensed in Wisconsin (40438-020) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Stoughton Hospital, and is a graduate of University Of Michigan Medical School (1992).

NPPES Registry Identity

NPI1528009644

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameSTEPHEN M BOORSTEINCredential: MD

Location Address752 N HIGH POINT RDMadison, WI 53717-2236

Mailing Address752 N High Point RdMadison, WI 53717-2236 · (608) 824-4800 · Fax (608) 824-4910

Phone(608) 824-4800

Fax(608) 824-4910

Sole ProprietorNo

Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1992

Enumeration DateJune 9, 2006

Last NPPES UpdateNovember 3, 2020

NPPES CertifiedNovember 3, 2020

✔ NPI 1528009644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in WI · 40438-020

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

752 N HIGH POINT RD, Madison, WI 53717

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Other Identifiers 1

Medicaid1528009644WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Providence Health Plan.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

Stephen M Boorstein 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 ID1951430867

PECOS Enrollment IDI20100602000068

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 17

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.

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

330 services165 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.

267 services187 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

214 services213 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

153 services151 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

145 services144 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

144 services92 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

129 services126 patients

Ct scan of cornea 92025

A CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.

123 services111 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.

118 services118 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

100 services100 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.

95 services84 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

59 services59 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.

48 services41 patients

Complex removal of cataract with insertion of prosthetic lens 66982

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

42 services32 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

37 services37 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

26 services26 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

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.

Stoughton Hospital

Critical Access Hospitals · Stoughton, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521343

Location900 Ridge StStoughton, WI 53589 · Dane County

Emergency services

Upland Hills Health

Critical Access Hospitals · Dodgeville, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521352

Location800 Compassion WayDodgeville, WI 53533 · Iowa County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53717 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

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

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%128 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

76%246 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…

25%251 patients2/55-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

60%131 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.

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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.

HEATHER L MUCKLER COTA

Occupational Therapy Assistant

752 N HIGH POINT RD
MADISON, WI 53717

Dane County (608) 824-4821

DR. MINDY BAUER PHARMD

Pharmacist

752 N HIGH POINT RD
MADISON, WI 53717

Dane County (608) 824-4500

DAVID K FALK MD

Dermatology

752 N HIGH POINT RD
MADISON, WI 53717

Dane County (608) 824-4000

DAVID A SORBER MD

Internal Medicine

752 N HIGH POINT RD, DEAN MEDICAL CENTER
MADISON, WI 53717

Dane County (608) 824-4800

JULIA L. THORSEN M.D.

Allergy & Immunology

752 N HIGH POINT RD
MADISON, WI 53717

Dane County (608) 824-4000

SARAH A OLIVER PA-C

Physician Assistant

752 N HIGH POINT RD
MADISON, WI 53717

Dane County (608) 824-4000

DR. GRANT MACAULAY M.D.

Internal Medicine

752 N HIGH POINT RD
MADISON, WI 53717

Dane County (608) 824-4000

DR. JUI B HAKER MD

Preventive Medicine (Occupational Medicine)

752 N HIGH POINT RD
MADISON, WI 53717

Dane County (608) 824-4000

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 Stephen Boorstein's NPI number?

The NPI number for Stephen Boorstein is 1528009644. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Where is Stephen Boorstein located?

Stephen Boorstein practices at 752 N High Point Rd, Madison, WI 53717. The listed phone number is (608) 824-4800.

What is Stephen Boorstein's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Stephen Boorstein enrolled in Medicare?

Yes. Stephen Boorstein 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.

What insurance does Stephen Boorstein accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana and Providence Health Plan list Stephen Boorstein 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 Stephen Boorstein affiliated with any hospitals?

According to CMS data, Stephen Boorstein is affiliated with Stoughton Hospital and Upland Hills Health.

When was this NPI record last updated?

The NPPES record for Stephen Boorstein was last updated on November 3, 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.