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DR. JAMES W VERBSKY MD
NPI 1528010113
Pediatrics - Pediatric Rheumatology in Milwaukee, WI

Active since May 16, 2006PECOS EnrolledAccepts Medicare Assignment
80.46/100
CMS Quality Rating
9000 W WISCONSIN AVE, PEDIATRIC RHEUMATOLOGY, MILWAUKEE, WI 53226(414) 266-6700(414) 266-6695 Get Directions Write a Review

NPPES record last updated: March 13, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. James W Verbsky Md NPPES

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

DR. JAMES W VERBSKY MD (NPI 1528010113) is an individual pediatric rheumatology provider in Milwaukee, Wisconsin, licensed in Wisconsin (48197) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Childrens Hospital Of Wisconsin, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1528010113
Entity TypeIndividualMale
Primary Taxonomy2080P0216X
Provider Legal NameDR. JAMES W VERBSKYCredential: MD
Location Address9000 W WISCONSIN AVE, PEDIATRIC RHEUMATOLOGYMilwaukee, WI 53226-4874
Mailing Address9000 W Wisconsin Ave, Pediatric RheumatologyMilwaukee, WI 53226-4874 · (414) 266-6700 · Fax (414) 266-6695
Phone(414) 266-6700
Fax(414) 266-6695
Sole ProprietorNo
Medical School CMSWashington University School Of MedicineGraduated 2000
Enumeration DateMay 16, 2006
Last NPPES UpdateMarch 13, 2024
NPPES CertifiedMarch 13, 2024
✔ NPI 1528010113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0216X
License✔ Licensed in WI · 48197
Definition
A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
9000 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12575 E Evergreen DriveAppleton, WI 54913 · Phone (920) 969-5353 · Fax (414) 337-7201
Location 29200 W Wisconsin AveMilwaukee, WI 53226-3522 · Phone (414) 955-7040 · Fax (414) 955-0175

Other Identifiers 2

Medicaid1528010113WI
Other039906262SHumana

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.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. James W Verbsky 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 ID5496764607
PECOS Enrollment IDI20060417000761
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 Reassignments

2

Medicare enrollment records show James Verbsky reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Children's Specialty Group, Inc.
Same address
Pediatrics
9000 W WISCONSIN AVE
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Childrens Specialty Group Inc
  • 424 clinicians in this Medicare group
NPI 1942970405 (414) 266-2000
The Medical College Of Wisconsin, Inc.
0.1 mi
Internal Medicine
8701 WATERTOWN PLANK RD
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • 3,983 clinicians in this Medicare group
NPI 1699720086 (414) 955-7101

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

Childrens Hospital Of Wisconsin

Childrens · Milwaukee, WI
OwnershipVoluntary non-profit - Other
CMS Certification Number523300
Location9000 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services

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.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.24
Promoting Interoperability100
Improvement Activities40
Cost68.64

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.

MS. LESLIE L. TALBERT NP
Nurse Practitioner (Pediatrics)
9000 W WISCONSIN AVE, PEDIATRIC CRITICAL CARE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-3360
SARAH MARIE RUMLER DO
Pediatrics (Pediatric Hematology-Oncology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-4170
ALISON COREN
Pediatrics (Pediatric Endocrinology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6750
BRANDON PALMER M.D.
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 337-7050
AIDAN JAMES REID DO
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6800
KYNDAL LYN HETTICH RD, CSP, CD
Dietitian, Registered
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-5938
CARISA MARIE DIMATTINA LCSW
Social Worker (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 581-4004
BREYA LOGAN WHITEFIELD PHD
Psychologist (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-2000

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 James Verbsky's NPI number?

The NPI number for James Verbsky is 1528010113. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is James Verbsky located?

James Verbsky practices at 9000 W Wisconsin Ave Pediatric Rheumatology, Milwaukee, WI 53226. The listed phone number is (414) 266-6700.

What is James Verbsky's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Rheumatology, with taxonomy code 2080P0216X.

Is James Verbsky enrolled in Medicare?

Yes. James Verbsky 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.

Which organizations bill Medicare for James Verbsky's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Verbsky reassigns Medicare benefits to 2 organizations: Children's Specialty Group, Inc. (Milwaukee, WI) and The Medical College Of Wisconsin, Inc. (Milwaukee, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Verbsky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Verbsky accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 1 other insurer list James Verbsky 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 James Verbsky affiliated with any hospitals?

According to CMS data, James Verbsky is affiliated with Childrens Hospital Of Wisconsin.

When was this NPI record last updated?

The NPPES record for James Verbsky was last updated on March 13, 2024. 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.