ROBERT ROTHBAUM M.D.
NPI 1679921381
Dermatology in Sheboygan, WI

Q: What is Robert Rothbaum's NPI number?

The NPI number for Robert Rothbaum is 1679921381. It was assigned to this individual provider in the NPPES registry on June 3, 2016.

Q: What is Robert Rothbaum's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Rothbaum was last updated on November 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since June 03, 2016PECOS EnrolledAccepts Medicare Assignment

94.1/100

CMS Quality Rating

2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081(920) 457-4461 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 5, 2024, Aug 13, 2024, Jun 19, 2020 and 1 more (4 updates tracked since 2019).

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About Robert Rothbaum M.d. NPPES

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

ROBERT ROTHBAUM M.D. (NPI 1679921381) is an individual dermatology provider in Sheboygan, Wisconsin, licensed in Wisconsin (3873-320) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of Boston University School Of Medicine (2016).

NPPES Registry Identity

NPI1679921381

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameROBERT ROTHBAUMCredential: M.D.

Location Address2414 KOHLER MEMORIAL DRSheboygan, WI 53081-3129

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250

Phone(920) 457-4461

Sole ProprietorNo

Medical School CMSBoston University School Of MedicineGraduated 2016

Enumeration DateJune 3, 2016

Last NPPES UpdateNovember 5, 20244 updates tracked since enumeration

NPPES CertifiedNovember 5, 2024

✔ NPI 1679921381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Licenses✔ Licensed in WI · 3873-320✔ Licensed in IL · 036.153199

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

2414 KOHLER MEMORIAL DR, Sheboygan, WI 53081

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Secondary Practice Location 1

Location 12820 W Devon AveChicago, IL 60659-1502 · Phone (312) 448-8953 · Fax (516) 518-1461

Other Identifiers 1

Medicaid100284235WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) 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

Robert Rothbaum 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 ID6608161518

PECOS Enrollment IDI20240815001164

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 7

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.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

76 services17 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.

42 services42 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

38 services38 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.

25 services19 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

21 services20 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

18 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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

$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.

94.1/100

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

Scored through an Alternative Payment Model

Quality

82.59

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

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

LAURA J MARKHAM PT

Physical Therapist