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DR. THOMAS VARGHESE MD
NPI 1538134028
Psychiatry & Neurology - Neurology in Brookfield, WI

Active since February 20, 2006PECOS EnrolledAccepts Medicare Assignment
82.39/100
CMS Quality Rating
13950 W CAPITOL DRIVE, BROOKFIELD, WI 53005(414) 302-5400(414) 302-5495 Get Directions Write a Review

NPPES record last updated: March 7, 2017. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Dr. Thomas Varghese Md NPPES

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

DR. THOMAS VARGHESE MD (NPI 1538134028) is an individual neurology provider in Brookfield, Wisconsin, licensed in Wisconsin (48234) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1538134028
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. THOMAS VARGHESECredential: MD
Location Address13950 W CAPITOL DRIVEBrookfield, WI 53005-2441
Mailing Address13950 W Capitol DriveBrookfield, WI 53005-2441 · (414) 302-5400 · Fax (414) 302-5495
Phone(414) 302-5400
Fax(414) 302-5495
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateFebruary 20, 2006
Last NPPES UpdateMarch 7, 2017
✔ NPI 1538134028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in WI · 48234
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
13950 W CAPITOL DRIVE, Brookfield, WI 53005
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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.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

Dr. Thomas Varghese 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 ID4284650375
PECOS Enrollment IDI20051018000845
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 4

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.

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.
342 services222 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.
71 services71 patients
Measurement of brain wave activity (eeg), awake and drowsy 95816
Measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This procedure is done when you're awake and drowsy to understand how your brain functions during different states of consciousness.
35 services34 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.
31 services31 patients

Hospital Affiliations CMS Care Compare 3

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

Ascension Columbia St Mary's Hospital Milwaukee

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520051
Location2323 N Lake DrMilwaukee, WI 53211 · Milwaukee County
Emergency services Birthing friendly

Ascension St Francis Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520078
Location3237 S 16th StMilwaukee, WI 53215 · Milwaukee County
Emergency services

Ascension SE Wisconsin Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520136
Location5000 W Chambers StMilwaukee, WI 53210 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53005 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
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
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.

82.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.88
Promoting Interoperability81
Improvement Activities40
Cost74.38

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier16 claims16 services$8.76 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

LYNN E DOLAN MD
Preventive Medicine (Occupational Medicine)
13950 W CAPITOL DRIVE
BROOKFIELD, WI 53005
Waukesha County (615) 778-4066
DARYL JOHN MELZER M.D.
Internal Medicine
13950 W CAPITOL DRIVE
BROOKFIELD, WI 53005
Waukesha County (414) 302-5404

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 Thomas Varghese's NPI number?

The NPI number for Thomas Varghese is 1538134028. It was assigned to this individual provider in the NPPES registry on February 20, 2006.

Where is Thomas Varghese located?

Thomas Varghese practices at 13950 W Capitol Drive, Brookfield, WI 53005. The listed phone number is (414) 302-5400.

What is Thomas Varghese's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Thomas Varghese enrolled in Medicare?

Yes. Thomas Varghese 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 Thomas Varghese accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Thomas Varghese 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 Thomas Varghese affiliated with any hospitals?

According to CMS data, Thomas Varghese is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, Ascension St Francis Hospital and Ascension SE Wisconsin Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Varghese was last updated on March 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.