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DR. RODNEY E WILLOUGHBY MD
NPI 1720030216
Pediatrics - Pediatric Infectious Diseases in Milwaukee, WI

Active since May 16, 2006PECOS EnrolledAccepts Medicare Assignment
80.46/100
CMS Quality Rating
9000 W WISCONSIN AVE, PEDIATRIC INFECTIOUS DISEASES, MILWAUKEE, WI 53226(414) 337-7070(414) 337-7093 Get Directions Write a Review

NPPES record last updated: September 25, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Rodney E Willoughby Md NPPES

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

DR. RODNEY E WILLOUGHBY MD (NPI 1720030216) is an individual pediatric infectious diseases provider in Milwaukee, Wisconsin, licensed in Wisconsin (46350) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Johns Hopkins University School Of Medicine (1982).

NPPES Registry Identity

NPI1720030216
Entity TypeIndividualMale
Primary Taxonomy2080P0208X
Provider Legal NameDR. RODNEY E WILLOUGHBYCredential: MD
Location Address9000 W WISCONSIN AVE, PEDIATRIC INFECTIOUS DISEASESMilwaukee, WI 53226-4874
Mailing Address9000 W Wisconsin Ave, Pediatric Infectious DiseasesMilwaukee, WI 53226-4874 · (414) 337-7070 · Fax (414) 337-7093
Phone(414) 337-7070
Fax(414) 337-7093
Sole ProprietorNo
Medical School CMSJohns Hopkins University School Of MedicineGraduated 1982
Enumeration DateMay 16, 2006
Last NPPES UpdateSeptember 25, 2014
✔ NPI 1720030216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Infectious DiseasesAllopathic & Osteopathic Physicians
Taxonomy Code2080P0208X
License✔ Licensed in WI · 46350
Definition
A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments.
9000 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Other Identifiers 4

Medicare UPINE30828
Medicare PIN023873601WI
Other000011354KHumana
Medicaid1720030216WI

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Rodney E Willoughby 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 ID3870561814
PECOS Enrollment IDI20040917001061
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Rodney Willoughby reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Children's Specialty Group, Inc.
0.1 mi
Pediatrics
9000 W WISCONSIN AVE
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Childrens Specialty Group Inc
  • 424 clinicians in this Medicare group
NPI 1942970405 (414) 266-2000
The Medical College Of Wisconsin, Inc.
0.2 mi
Internal Medicine
8701 WATERTOWN PLANK RD
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • 3,983 clinicians in this Medicare group
NPI 1699720086 (414) 955-7101

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.24
Promoting Interoperability100
Improvement Activities40
Cost68.64

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.

MS. LESLIE L. TALBERT NP
Nurse Practitioner (Pediatrics)
9000 W WISCONSIN AVE, PEDIATRIC CRITICAL CARE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-3360
SARAH MARIE RUMLER DO
Pediatrics (Pediatric Hematology-Oncology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-4170
ALISON COREN
Pediatrics (Pediatric Endocrinology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6750
BRANDON PALMER M.D.
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 337-7050
AIDAN JAMES REID DO
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6800
KYNDAL LYN HETTICH RD, CSP, CD
Dietitian, Registered
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-5938
CARISA MARIE DIMATTINA LCSW
Social Worker (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 581-4004
BREYA LOGAN WHITEFIELD PHD
Psychologist (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-2000

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 Rodney Willoughby's NPI number?

The NPI number for Rodney Willoughby is 1720030216. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Rodney Willoughby located?

Rodney Willoughby practices at 9000 W Wisconsin Ave Pediatric Infectious Diseases, Milwaukee, WI 53226. The listed phone number is (414) 337-7070.

What is Rodney Willoughby's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Infectious Diseases, with taxonomy code 2080P0208X.

Is Rodney Willoughby enrolled in Medicare?

Yes. Rodney Willoughby 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.

Which organizations bill Medicare for Rodney Willoughby's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rodney Willoughby reassigns Medicare benefits to 2 organizations: Children's Specialty Group, Inc. (Milwaukee, WI) and The Medical College Of Wisconsin, Inc. (Milwaukee, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rodney Willoughby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Rodney Willoughby accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and UnitedHealthcare list Rodney Willoughby 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.

When was this NPI record last updated?

The NPPES record for Rodney Willoughby was last updated on September 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.