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JAMES C SCHEMMEL MD
NPI 1689617706
Otolaryngology in Madison, WI

Active since June 14, 2006PECOS EnrolledAccepts Medicare Assignment
1313 FISH HATCHERY RD, MADISON, WI 53715(608) 252-8000(608) 283-7381 Get Directions Write a Review

NPPES record last updated: December 8, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About James C Schemmel Md NPPES

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

JAMES C SCHEMMEL MD (NPI 1689617706) is an individual otolaryngology provider in Madison, Wisconsin, licensed in Wisconsin (28585-020) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Clare Hospital - Baraboo, and maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1689617706
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameJAMES C SCHEMMELCredential: MD
Location Address1313 FISH HATCHERY RDMadison, WI 53715-1911
Mailing Address1313 Fish Hatchery RdMadison, WI 53715-1911 · (608) 252-8000 · Fax (608) 283-7381
Phone(608) 252-8000
Fax(608) 283-7381
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 1986
Enumeration DateJune 14, 2006
Last NPPES UpdateDecember 8, 2020
NPPES CertifiedDecember 8, 2020
✔ NPI 1689617706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in WI · 28585-020
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1313 FISH HATCHERY RD, Madison, WI 53715
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Secondary Practice Location 1

Location 11313 Fish Hatchery RdMadison, WI 53715-1911 · Phone (608) 252-8000 · Fax (608) 283-7381

Other Identifiers 1

Medicaid1689617706WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

James C Schemmel 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 ID244369213
PECOS Enrollment IDI20100601000381
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 8

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 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.
280 services219 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.
189 services189 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.
155 services110 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
84 services82 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.
57 services57 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
50 services48 patients

Hospital Affiliations CMS Care Compare 2

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53715 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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
44%206 patients2/55-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
88%288 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…
27%338 patients2/55-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
74%133 patients4/55-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 3

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

Tracheostomy, inner cannula A4623
DME-Orthotic Devices · category DF000N
1 supplier14 claims770 services$6.33 avg. paid by Medicare
Tracheostomy care kit for established tracheostomy A4629
DME-Orthotic Devices · category DF000N
2 suppliers11 claims630 services$4.50 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6209
DME-Medical/Surgical Supplies · category DA023N
2 suppliers12 claims325 services$7.23 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 20

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

BRIAN J APEL
Pharmacist
1313 FISH HATCHERY RD, SUITE 300
MADISON, WI 53715
Dane County (608) 252-8044
ANN HERROLD-PETERSON LCSW
Social Worker (Clinical)
1313 FISH HATCHERY RD, DEAN MEDICAL CENTER
MADISON, WI 53715
Dane County (608) 252-8000
MRS. JAN LOUISE BASOM SCHUBERT MA
Social Worker (Clinical)
1313 FISH HATCHERY RD
MADISON, WI 53715
Dane County (608) 252-8000
ERIC HUCKINS PHARMD
Pharmacist
1313 FISH HATCHERY RD
MADISON, WI 53715
Dane County (608) 294-3784
JOAN V. BROWN PA-C
Physician Assistant
1313 FISH HATCHERY RD
MADISON, WI 53715
Dane County (608) 252-8000
RUSSELL G ROHRDANZ AUD
Audiologist
1313 FISH HATCHERY RD, DEAN MEDICAL CENTER
MADISON, WI 53715
Dane County (608) 252-8000
LINDA WILHELMI LCSW
Social Worker (Clinical)
1313 FISH HATCHERY RD, DEAN MEDICAL CENTER
MADISON, WI 53715
Dane County (608) 252-8000
PAUL M REBER DO
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1313 FISH HATCHERY RD
MADISON, WI 53715
Dane County (608) 252-8000

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 James Schemmel's NPI number?

The NPI number for James Schemmel is 1689617706. It was assigned to this individual provider in the NPPES registry on June 14, 2006.

Where is James Schemmel located?

James Schemmel practices at 1313 Fish Hatchery Rd, Madison, WI 53715. The listed phone number is (608) 252-8000.

What is James Schemmel's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is James Schemmel enrolled in Medicare?

Yes. James Schemmel 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 James Schemmel accept?

Health plans from Anthem Blue Cross and Blue Shield list James Schemmel 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 James Schemmel affiliated with any hospitals?

According to CMS data, James Schemmel is affiliated with Ssm Health St Clare Hospital - Baraboo and Ssm Health St Mary's Hospital - Madison.

When was this NPI record last updated?

The NPPES record for James Schemmel was last updated on December 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.