MR. SIMON EDWIN ROSELAAR MD
NPI 1689626632
Internal Medicine - Cardiovascular Disease in Appleton, WI

Active since May 17, 2006PECOS EnrolledAccepts Medicare Assignment
77.77/100
CMS Quality Rating
5045 W GRANDE MARKET DR, APPLETON, WI 54913(920) 886-9380(920) 886-9381 Get Directions Write a Review

NPPES record last updated: March 26, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Simon Edwin Roselaar Md NPPES

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

MR. SIMON EDWIN ROSELAAR MD (NPI 1689626632) is an individual cardiovascular disease provider in Appleton, Wisconsin, licensed in Wisconsin (40974-020) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Ne Wisconsin - St Elizabeth Campus, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1689626632
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameMR. SIMON EDWIN ROSELAARCredential: MD
Location Address5045 W GRANDE MARKET DRAppleton, WI 54913-8517
Mailing AddressBin 88040Milwaukee, WI 53288-0040 · (920) 886-9380 · Fax (920) 886-9381
Fax(920) 886-9381
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateMay 17, 2006
Last NPPES UpdateMarch 26, 2020
NPPES CertifiedMarch 26, 2020
NPI 1689626632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in WI · 40974-020
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal MedicineTaxonomy 207R00000X · License 40974-020 (WI)
Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X · License 40974-020 (WI)
5045 W GRANDE MARKET DR, Appleton, WI 54913

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

Mr. Simon Edwin Roselaar 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 ID8325951338
PECOS Enrollment IDI20050222000561
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 32

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.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
6,515 services65 patients
Injection, propofol, 10 mg J2704
Propofol is a medication given via injection to help you relax or sleep during surgery or other medical procedures. The 10 mg dosage refers to the amount of medication you'll receive. It's administered by a healthcare professional and monitored closely for safety.
448 services34 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.
331 services253 patients
Injection, regadenoson, 0.1 mg J2785
Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
308 services77 patients
Technetium tc-99m tetrofosmin, diagnostic, per study dose A9502
Technetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.
283 services142 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
206 services206 patients

Hospital Affiliations CMS Care Compare 4

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

Ascension NE Wisconsin - St Elizabeth Campus

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520009
Location1506 S Oneida StAppleton, WI 54915 · Outagamie County
Emergency services Birthing friendly

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520045
Location130 2nd StNeenah, WI 54956 · Winnebago County
Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520160
Location1818 N Meade StAppleton, WI 54911 · Outagamie County
Emergency services Birthing friendly

Berlin Memorial Hospital

Critical Access Hospitals · Berlin, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521355
Location225 Memorial DriveBerlin, WI 54923 · Green Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54913 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.

77.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.47
Promoting Interoperability77
Improvement Activities40
Cost63.8

Other Providers at the Same Location NPPES 18

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

Nurse Practitioner
5045 W GRANDE MARKET DR
APPLETON, WI 54913
Internal Medicine (Cardiovascular Disease)
5045 W GRANDE MARKET DR
APPLETON, WI 54913
Internal Medicine (Interventional Cardiology)
5045 W GRANDE MARKET DR
APPLETON, WI 54913
Physician Assistant
5045 W GRANDE MARKET DR
APPLETON, WI 54913
Nurse Practitioner
5045 W GRANDE MARKET DR
APPLETON, WI 54913
Nurse Practitioner
5045 W GRANDE MARKET DR
APPLETON, WI 54913
Internal Medicine (Cardiovascular Disease)
5045 W GRANDE MARKET DR
APPLETON, WI 54913
Internal Medicine (Cardiovascular Disease)
5045 W GRANDE MARKET DR
APPLETON, WI 54913

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 Simon Roselaar's NPI number?

The NPI number for Simon Roselaar is 1689626632. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Where is Simon Roselaar located?

Simon Roselaar practices at 5045 W Grande Market Dr, Appleton, WI 54913. The listed phone number is (920) 886-9380.

What is Simon Roselaar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Simon Roselaar enrolled in Medicare?

Yes. Simon Roselaar 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 Simon Roselaar accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare) and Network Health list Simon Roselaar 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 Simon Roselaar affiliated with any hospitals?

According to CMS data, Simon Roselaar is affiliated with Ascension NE Wisconsin - St Elizabeth Campus, Thedacare Regional Med Ctr - Neenah, Thedacare Regional Medical Center - Appleton Inc and Berlin Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Simon Roselaar was last updated on March 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.