|Provider Name||ELLEN A RADOCAY APNP|
|Location Address||140B SCHOOL CREEK TRL LUXEMBURG, WI 54217|
|Location Phone||(920) 845-1370|
|Mailing Address||PO BOX 22487 GREEN BAY GREEN BAY, WI 54305|
|NPI Entity Type||Individual|
|Medical School Name||OTHER|
|Is Sole Proprietor?||No|
|Last Update Date||07-21-2020|
A nurse practitioner (NP) like Ellen Radocay is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.Ellen Radocay is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Ellen Radocay is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Bellin Memorial Hospital.
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.4 for a new patient copayment and $24.86 for an established patient copayment.
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
|Type||Physician Assistants & Advanced Practice Nursing Providers|
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
140B SCHOOL CREEK TRL
Phone: (920) 845-1370
Fax: (920) 845-1379
PO BOX 22487
GREEN BAY, WI
Phone: (920) 445-7210
Fax: (920) 445-7289
723 S Wisconsin St
Pulaski, WI 54162
(920) 822-1100405 Commercial St
Seymour, WI 54165
(920) 833-2318831 Parker St Algoma
Algoma, WI 54201
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
|Registered in PECOS?||Yes|
|PECOS PAC ID||6709006885|
|PECOS Enrollment ID||I20141014000383|
|Accepts Medicare Assignment?|| Yes "What does it mean "accepts medicare assignment"?|
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
|Eligible order / refer Part B Clinical Laboratory and Imaging||Yes|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||Yes|
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 54217 ZIP code area.
|New Patients Office Visits Costs *|
|Most Utilized Procedure Code for new patients office visits: 99203|
|Minimum New Patient Pricing||Maximum New Patient Pricing||Typical New Patient Pricing|
|Minimum New Patient Copayment||Maximum New Patient Copayment||Typical New Patient Copayment|
|Established Patients Office Visits Costs *|
|Most Utilized Procedure Code for established patients office visits: 99214|
|Minimum Established Patient Pricing||Maximum Established Patient Pricing||Typical Established Patient Pricing|
|Minimum Established Patient Copayment||Maximum Established Patient Copayment||Typical Established Patient Copayment|
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 78Insertion of needle into vein for collection of blood sample (HCPCS:36415)
- 37Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
- 17Hemoglobin a1c level (HCPCS:83036)
- 15Administration of influenza virus vaccine (HCPCS:G0008)
- 12Vaccine for influenza for injection into muscle (HCPCS:90662)
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Ellen Radocay is affiliated with the following medical facilities:
|Hospital Name||Address||Phone||Hospital Type||CMS Certification Number (CCN)||Overall Rating|
|BELLIN MEMORIAL HOSPITAL||744 S WEBSTER AVE|
GREEN BAY, WI 54305
|(920) 433-3500||Acute Care Hospitals||520049|
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
|No.||Taxonomy Code||Type||Classification||Specialization||License No.||State||Primary|
|1||163W00000X||Nursing Service Providers||Registered Nurse||174211-30||WI||No|
Taxonomy Description: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State||Identifier Issuer|
|F0814117||OTHER (01)||AMERICAN ACADEMY OF NURSE PRACTITIONERS|
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
|Start with the original NPI number, the last digit is the check digit and is not used in the calculation.|
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.|
|2 + 5 + 6 + 8 + 1 + 0 + 7 + 1 + 0 + 0 + 8 + 24 = 62|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|70 - 62 = 8||8|
The NPI number 1538575048 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
|NPI||Name / Type||Taxonomy||Address|
|1609252139|| ELYSE MARIE ENGEBOSE FNP-C |
|Nurse Practitioner (Family)||140B SCHOOL CREEK TRL |
LUXEMBURG, WI 54217
Frequently Asked Questions
What is Ellen Radocay APNP NPI number?
The NPI number assigned to this healthcare provider is 1538575048, registered as an "individual" on July 03, 2014
Where is the provider located?
The provider is located at 140b School Creek Trl Luxemburg, Wi 54217 and the phone number is (920) 845-1370
What is the provider specialty code?
The provider's speciality is Nurse Practitioner with taxonomy code 363LF0000X with a focus in Family
How many years of experience does Ellen Radocay APNP have?
The provider has more than 10 years of experience.
What insurance does Ellen Radocay APNP accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Ellen Radocay APNP registered in PECOS?
Yes, as of September 14, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
How much is a visit to Ellen Radocay APNP?
Medicare beneficiaries should expect a typical cost of $85.6 with an average copayment of $21.4 for new patient appointments. Established patients should expect a typical charge of $99.45 and an average copayment of 24.86. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Ellen Radocay APNP?
The most common procedures or services performed by this practitioner are: Insertion of needle into vein for collection of blood sample, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Hemoglobin a1c level, Administration of influenza virus vaccine and Vaccine for influenza for injection into muscle.
Is Ellen Radocay APNP affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: BELLIN MEMORIAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Ellen Radocay APNP was last updated on July 03, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.