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CRAIG R KELMAN MD
NPI 1528350436
Neurological Surgery in Wausau, WI

Active since May 11, 2011PECOS EnrolledAccepts Medicare Assignment
84.55/100
CMS Quality Rating
425 PINE RIDGE BLVD STE 300, WAUSAU, WI 54401(715) 847-2000 Get Directions Write a Review

NPPES record last updated: June 27, 2018. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 27, 2018, Jul 20, 2017 (2 updates tracked since 2017).

About Craig R Kelman Md NPPES

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

CRAIG R KELMAN MD (NPI 1528350436) is an individual neurological surgery provider in Wausau, Wisconsin, licensed in Wisconsin (68818-20) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS, is affiliated with Aspirus Stevens Point Hospital & Clinics, Inc., and is a graduate of Other (2011).

NPPES Registry Identity

NPI1528350436
Entity TypeIndividualMale
Primary Taxonomy207T00000X
Provider Legal NameCRAIG R KELMANCredential: MD
Location Address425 PINE RIDGE BLVD STE 300Wausau, WI 54401
Mailing Address425 Pine Ridge Blvd Ste 300Wausau, WI 54401-4124
Phone(715) 847-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateMay 11, 2011
Last NPPES UpdateJune 27, 20182 updates tracked since enumeration
✔ NPI 1528350436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
Licenses✔ Licensed in WI · 68818-20✔ Licensed in VA · 0101262140
Definition
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
425 PINE RIDGE BLVD STE 300, Wausau, WI 54401
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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, Aspirus Health Plan, HealthPartners 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

Craig R Kelman 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 ID2365681608
PECOS Enrollment IDI20180702003400
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 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.

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.
54 services54 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.
45 services41 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
36 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.
24 services22 patients
Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047
This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.
22 services22 patients
Computer-assisted spinal procedure 61783
A computer-assisted spinal procedure is a surgical technique that uses computer technology for improved precision. It involves creating a 3D image of your spine to guide the surgeon during the operation. This method enhances accuracy, reduces risk, and promotes quicker recovery.
12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Aspirus Stevens Point Hospital & Clinics, Inc.

Acute Care Hospitals · Stevens Point, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520002
Location900 Illinois AveStevens Point, WI 54481 · Portage County
Emergency services Birthing friendly

Aspirus Rhinelander Hospital

Acute Care Hospitals · Rhinelander, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520019
Location2251 North Shore DrRhinelander, WI 54501 · Oneida County
Emergency services Birthing friendly

Aspirus Wausau Hospital

Acute Care Hospitals · Wausau, WI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number520030
Location333 Pine Ridge BlvdWausau, WI 54401 · Marathon County
Emergency services Birthing friendly

Aspirus Riverview Hospital & Clinics Inc

Acute Care Hospitals · Wisconsin Rapids, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520033
Location410 Dewey StWisconsin Rapids, WI 54495 · Wood County
Emergency services

Aspirus Medford Hospital & Clinics, Inc

Critical Access Hospitals · Medford, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521324
Location135 S Gibson StMedford, WI 54451 · Taylor County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54401 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.

84.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.81
Promoting Interoperability100
Improvement Activities40
Cost53.8

Other Providers at the Same Location NPPES 3

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

DR. SANDEEP AGGARWAL MD
Psychiatry & Neurology (Neurology)
425 PINE RIDGE BLVD STE 300
WAUSAU, WI 54401
Marathon County (715) 847-2019
RODRIGO R MERINO MD
Psychiatry & Neurology (Neurology)
425 PINE RIDGE BLVD STE 300
WAUSAU, WI 54401
Marathon County (715) 847-2019
DANA LEIGH STUARD
Nurse Practitioner (Family)
425 PINE RIDGE BLVD STE 300
WAUSAU, WI 54401
Marathon County (715) 297-0475

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 Craig Kelman's NPI number?

The NPI number for Craig Kelman is 1528350436. It was assigned to this individual provider in the NPPES registry on May 11, 2011.

Where is Craig Kelman located?

Craig Kelman practices at 425 Pine Ridge Blvd Ste 300, Wausau, WI 54401. The listed phone number is (715) 847-2000.

What is Craig Kelman's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Is Craig Kelman enrolled in Medicare?

Yes. Craig Kelman 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 Craig Kelman accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and Security Health Plan list Craig Kelman 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 Craig Kelman affiliated with any hospitals?

According to CMS data, Craig Kelman is affiliated with Aspirus Stevens Point Hospital & Clinics, Inc., Aspirus Rhinelander Hospital, Aspirus Wausau Hospital, Aspirus Riverview Hospital & Clinics Inc and Aspirus Medford Hospital & Clinics, Inc.

When was this NPI record last updated?

The NPPES record for Craig Kelman was last updated on June 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.