ANTHONY JAMES STURM M.D.
NPI 1619243474
Family Medicine in Madison, WI

Active since March 27, 2012PECOS EnrolledAccepts Medicare Assignment
4901 COTTAGE GROVE RD, MADISON, WI 53719(608) 221-1501(608) 223-3540 Get Directions Write a Review

NPPES record last updated: November 2, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 2, 2020, Oct 19, 2020 (2 updates tracked since 2020).

About Anthony James Sturm M.d. NPPES

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

ANTHONY JAMES STURM M.D. (NPI 1619243474) is an individual family medicine provider in Madison, Wisconsin, licensed in Wisconsin (61420) and active in the NPI registry since March 2012. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Clare Hospital - Baraboo, and is a graduate of University Of Wisconsin School Of Medicine (2011).

NPPES Registry Identity

NPI1619243474
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameANTHONY JAMES STURMCredential: M.D.
Location Address4901 COTTAGE GROVE RDMadison, WI 53719-1392
Mailing Address4901 Cottage Grove RdMadison, WI 53719-1392 · (608) 221-1501 · Fax (608) 223-3540
Fax(608) 223-3540
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2011
Enumeration DateMarch 27, 2012
Last NPPES UpdateNovember 2, 20202 updates tracked since enumeration
NPPES CertifiedNovember 2, 2020
NPI 1619243474 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 · 61420
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.

4901 COTTAGE GROVE RD, Madison, WI 53719

Accepted 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

Anthony James Sturm M.d. 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 ID2466676770
PECOS Enrollment IDI20150716001915
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 17

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
209 services133 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.
204 services135 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.
167 services127 patients
Blood test, basic group of blood chemicals (calcium, total) 80048
A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.
126 services93 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.
95 services95 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
87 services82 patients

Hospital Affiliations CMS Care Compare 4

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

Ssm Health St Clare Hospital - Baraboo

Acute Care Hospitals · Baraboo, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520057
Location707 14th StBaraboo, WI 53913 · Sauk County
Emergency services Birthing friendly

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520083
Location700 South Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Stoughton Hospital

Critical Access Hospitals · Stoughton, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521343
Location900 Ridge StStoughton, WI 53589 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53719 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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
63%134 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
95%169 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
22%192 patients1/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
51%68 patients3/55-star benchmark: 98%
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 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers21 claims69 services$4.51 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier15 claims15 services$81.08 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
3 suppliers12 claims1,680 services$0.08 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
1 supplier11 claims11 services$33.12 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
3 suppliers11 claims11 services$18.99 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Anthony Sturm's NPI number?

The NPI number for Anthony Sturm is 1619243474. It was assigned to this individual provider in the NPPES registry on March 27, 2012.

Where is Anthony Sturm located?

Anthony Sturm practices at 4901 Cottage Grove Rd, Madison, WI 53719. The listed phone number is (608) 221-1501.

What is Anthony Sturm's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Anthony Sturm enrolled in Medicare?

Yes. Anthony Sturm 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 Anthony Sturm accept?

Health plans from Anthem Blue Cross and Blue Shield and Quartz list Anthony Sturm 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 Anthony Sturm affiliated with any hospitals?

According to CMS data, Anthony Sturm is affiliated with Ssm Health St Clare Hospital - Baraboo, Ssm Health St Mary's Hospital - Madison, University Of Wi Hospitals & Clinics Authority and Stoughton Hospital.

When was this NPI record last updated?

The NPPES record for Anthony Sturm was last updated on November 2, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.