DR. SWATI AGARWAL-SINHA MD
NPI 1659578623
Ophthalmology in Green Bay, WI

Q: What is Swati Agarwal-sinha's NPI number?

The NPI number for Swati Agarwal-sinha is 1659578623. It was assigned to this individual provider in the NPPES registry on July 2, 2007.

Q: What is Swati Agarwal-sinha's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since July 02, 2007PECOS EnrolledAccepts Medicare Assignment

93.09/100

CMS Quality Rating

480 PILGRIM WAY STE 1305, GREEN BAY, WI 54304(920) 592-0111(920) 592-1146 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Oct 8, 2025, Feb 18, 2022, Jun 1, 2020 and 1 more (4 updates tracked since 2016).

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About Dr. Swati Agarwal-sinha Md NPPES

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

DR. SWATI AGARWAL-SINHA MD (NPI 1659578623) is an individual ophthalmology provider in Green Bay, Wisconsin, licensed in Wisconsin (50587-20) and active in the NPI registry since July 2007. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and maintains a secondary practice location in Appleton.

NPPES Registry Identity

NPI1659578623

Entity TypeIndividualFemale

Primary Taxonomy207W00000X

Provider Legal NameDR. SWATI AGARWAL-SINHACredential: MD

Location Address480 PILGRIM WAY STE 1305Green Bay, WI 54304-5279

Mailing Address442 N Westhill Blvd Ste AAppleton, WI 54914-5830 · (920) 751-8666 · Fax (920) 751-8676

Phone(920) 592-0111

Fax(920) 592-1146

Sole ProprietorNo

Medical School CMSOtherGraduated 1994

Enumeration DateJuly 2, 2007

Last NPPES UpdateOctober 8, 20254 updates tracked since enumeration

NPPES CertifiedOctober 8, 2025

✔ NPI 1659578623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Licenses✔ Licensed in WI · 50587-20✔ Licensed in WA · MD61238685✔ Licensed in FL · MFC1722

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X · License 50587-20 (WI), MD61238685 (WA)

480 PILGRIM WAY STE 1305, Green Bay, WI 54304

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Secondary Practice Location 1

Location 1442 N Westhill Blvd Ste AAppleton, WI 54914-5830 · Phone (920) 751-8666 · Fax (920) 751-8676

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross and Blue Shield of Montana 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

Dr. Swati Agarwal-sinha 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 ID4486745023

PECOS Enrollment IDI20070810000309

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 13

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.

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

237 services205 patients

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.

109 services109 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

105 services94 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.

104 services99 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

99 services70 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

62 services57 patients

Injection, bevacizumab, 10 mg J9035

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

59 services38 patients

Imaging of retina 92134

51 services48 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

48 services16 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

28 services27 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

16 services15 patients

Injection of drug into eye 67028

15 services12 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.

14 services12 patients

Hospital Affiliations CMS Care Compare

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54304 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.

93.09/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

73.95

Promoting Interoperability

100

Improvement Activities

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 Swati Agarwal-sinha's NPI number?

The NPI number for Swati Agarwal-sinha is 1659578623. It was assigned to this individual provider in the NPPES registry on July 2, 2007.

Where is Swati Agarwal-sinha located?

Swati Agarwal-sinha practices at 480 Pilgrim Way Ste 1305, Green Bay, WI 54304. The listed phone number is (920) 592-0111.

What is Swati Agarwal-sinha's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Swati Agarwal-sinha enrolled in Medicare?

Yes. Swati Agarwal-sinha 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 Swati Agarwal-sinha accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Swati Agarwal-sinha 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 Swati Agarwal-sinha affiliated with any hospitals?

According to CMS data, Swati Agarwal-sinha is affiliated with St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Swati Agarwal-sinha was last updated on October 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.