KELLY T BADGER MD
NPI 1558523258
Family Medicine in Oshkosh, WI
Active since June 25, 2008PECOS EnrolledAccepts Medicare Assignment
82.79/100
CMS Quality Rating
About Kelly T Badger Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY T BADGER MD (NPI 1558523258) is an individual family medicine provider in Oshkosh, Wisconsin, licensed in Wisconsin (555699) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS, is affiliated with Aspirus Wausau Hospital, and is a graduate of University Of Wisconsin School Of Medicine (2008).
NPPES Registry Identity
NPI1558523258
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKELLY T BADGERCredential: MD
Location Address2725 JACKSON STOshkosh, WI 54901-1513
Mailing Address2725 Jackson StOshkosh, WI 54901-1513 · (920) 223-7500
Phone(920) 223-7500
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2008
Enumeration DateJune 25, 2008
Last NPPES UpdateMay 5, 2022
NPPES CertifiedMay 5, 2022
✔ NPI 1558523258 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 555699
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2725 JACKSON ST, Oshkosh, WI 54901
Other Names 1
Former Name (1)Kelly T Krueger Md
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Medica 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
Kelly T Badger 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 ID8527236850
PECOS Enrollment IDI20110712000620
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.
222 services154 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
121 services121 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.
50 services41 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
28 services27 patients
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Aspirus Wausau Hospital
Acute Care Hospitals · Wausau, WIOwnershipProprietary
CMS Certification Number520030
Location333 Pine Ridge BlvdWausau, WI 54401 · Marathon County
Emergency services Birthing friendly
Marshfield Medical Center
Acute Care Hospitals · Marshfield, WIOwnershipVoluntary non-profit - Church
CMS Certification Number520037
Location611 St Joseph AveMarshfield, WI 54449 · Wood County
Emergency services Birthing friendly
Marshfield Medical Center - Weston
Acute Care Hospitals · Weston, WIOwnershipVoluntary non-profit - Private
CMS Certification Number520202
Location3400 Ministry ParkwayWeston, WI 54476 · Marathon County
Emergency services Birthing friendly
Marshfield Medical Center - Minocqua
Acute Care Hospitals · Minocqua, WIOwnershipVoluntary non-profit - Private
CMS Certification Number520212
Location9576 Highway 70Minocqua, WI 54548 · Oneida County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54901 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
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.
82.79/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
68.98
Promoting Interoperability
99
Improvement Activities
40
Cost
66.19
Reported Quality Measures
Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
0%35 patients
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
78%426 patients4/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
82%344 patients4/55-star benchmark: 100%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
70%648 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
86%596 patients5/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 44% · 72 patients
Patients 4MonthsOfStart: 15% · 72 patients
17%52 patients
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
37%123 patients2/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,075 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%4,547 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
56%369 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
83%155 patients1/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
88%1,831 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
39%954 patients2/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
75%1,831 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
41%1,831 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
43%1,831 patients
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.
Referred Medical Equipment & Supplies CMS DME claims 8
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise L0637
DME-Orthotic Devices · category DF007N
5 suppliers29 claims29 services$1,050.68 avg. paid by Medicare
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0650
DME-Orthotic Devices · category DF007N
9 suppliers31 claims31 services$763.57 avg. paid by Medicare
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf L0651
DME-Orthotic Devices · category DF007N
10 suppliers70 claims70 services$786.47 avg. paid by Medicare
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise L1843
DME-Orthotic Devices · category DF011N
2 suppliers25 claims50 services$738.51 avg. paid by Medicare
Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf L1851
DME-Orthotic Devices · category DF011N
8 suppliers24 claims44 services$596.56 avg. paid by Medicare
Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf L1852
DME-Orthotic Devices · category DF011N
10 suppliers60 claims112 services$572.26 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 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Clinic/Center (Multi-Specialty)
2725 JACKSON ST
OSHKOSH, WI 54901
OSHKOSH, WI 54901
Specialist/Technologist (Athletic Trainer)
2725 JACKSON ST
OSHKOSH, WI 54901
OSHKOSH, WI 54901
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 Kelly Badger's NPI number?
The NPI number for Kelly Badger is 1558523258. It was assigned to this individual provider in the NPPES registry on June 25, 2008. The provider is also known as Kelly T Krueger MD.
Where is Kelly Badger located?
Kelly Badger practices at 2725 Jackson St, Oshkosh, WI 54901. The listed phone number is (920) 223-7500.
What is Kelly Badger's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kelly Badger enrolled in Medicare?
Yes. Kelly Badger 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 Kelly Badger accept?
Health plans from Anthem Blue Cross and Blue Shield, HealthPartners, Medica, Sanford Health Plan and Security Health Plan list Kelly Badger 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 Kelly Badger affiliated with any hospitals?
According to CMS data, Kelly Badger is affiliated with Aspirus Wausau Hospital, Marshfield Medical Center, Marshfield Medical Center - Weston and Marshfield Medical Center - Minocqua.
When was this NPI record last updated?
The NPPES record for Kelly Badger was last updated on May 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kelly T Badger, MD · NPI 1558523258
Family Medicine physician in Oshkosh, Wisconsin. Individual provider, active in the CMS NPPES registry since June 25, 2008.
## Identity
- **NPI:** 1558523258 (Entity type: Individual)
- **Enumerated:** June 25, 2008
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 555699 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 2725 JACKSON ST, Oshkosh, WI 54901-1513
- **Phone:** (920) 223-7500
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of Wisconsin School Of Medicine, class of 2008
## Record status
- **NPPES last updated:** May 5, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1558523258) · Data from the CMS NPPES public registry.