DR. BRETT JOHN BORDINI M.D.
NPI 1730244583
Pediatrics in Milwaukee, WI

Quality Rating: 78.74 out of 100 score

NPI Status: Active since December 22, 2006

Contact Information

999 N 92ND ST
CHILDREN'S CORPORATE CENTER SUITE C560
MILWAUKEE, WI
ZIP 53226
Phone: (414) 337-7050
Fax: (414) 337-7020

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Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
Overall Quality Performance
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Pediatrics
Accepts Insurance
PECOS Enrolled

About BRETT BORDINI

This page provides the complete NPI Profile along with additional information for Brett Bordini, a pediatrician established in Milwaukee, Wisconsin with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1730244583 assigned on December 2006. The practitioner's primary taxonomy code is 208000000X with license number 51579-020 (WI). The provider is registered as an individual and his NPI record was last updated 16 years ago.

NPI: 1730244583
Provider Name: DR. BRETT JOHN BORDINI M.D.
Gender: Male
Entity Type: Individual
Location Address: 999 N 92ND ST CHILDREN'S CORPORATE CENTER SUITE C560 MILWAUKEE, WI 53226
Location Phone: (414) 337-7050
Location Fax: (414) 337-7020
Mailing Address: 999 N 92ND ST CHILDREN'S CORPORATE CENTER SUITE C560 PO BOX 1997 MILWAUKEE, WI 53226
Mailing Phone: (414) 337-7050
Mailing Fax: (414) 337-7020
Is Sole Proprietor?: No
Enumeration Date: 12-22-2006
Last Update Date: 12-16-2009
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A pediatrician like Brett Bordini is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Pediatrics
Taxonomy Code: 208000000X
Type: Allopathic & Osteopathic Physicians
License No.: 51579-020
License State: WI
Taxonomy Description: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
Anthem Silver Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Silver Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

Aspirus Health Plan

HMO Bronze $0 Medical Deductible - HMO
HMO Bronze 7500 - HMO
HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
HMO Gold 1500 - HMO
HMO Gold 2400 - HMO
HMO HDHP Bronze 7200 - HMO
HMO HDHP Silver 5400 - HMO
HMO Silver 5000 - HMO
HMO Silver 6600 - HMO
POS Bronze 7500 - POS
POS HDHP Bronze 6250 - POS
POS Silver 5000 - POS

Common Ground Healthcare Cooperative

CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
CGHC Bronze Standard $7500 - Envision Network - EPO
CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
CGHC Catastrophic $9200 - Envision Network - EPO
CGHC Gold $0 Ded - Envision Network - EPO
CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
CGHC Gold $3000 - Envision Network - EPO
CGHC Gold $3000 - Envision Network (Vision Exam) - EPO
CGHC Gold Standard $1500 - Envision Network - EPO
CGHC Gold Standard $1500 - Envision Network (Vision Exam) - EPO
CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network - EPO
CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network (Vision Exam) - EPO
CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network - EPO
CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network (Vision Exam) - EPO
CGHC Silver Standard $5000 - Envision Network - EPO
CGHC Silver Standard $5000 - Envision Network (Vision Exam) - EPO

Molina Healthcare

Gold 1 - HMO
Gold 1 with Adult Vision Services - HMO
Gold 8 - HMO
Silver 1 - HMO
Silver 1 with Adult Vision Services - HMO
Silver 12 with First 4 Primary Care Visits Free - HMO
Silver 8 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Brett Bordini is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53226 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $82.92
Minimum New Patient Price $53.9
Maximum New Patient Price $163.24

Average New Patient Copayment $20.73
Minimum New Patient Copayment $13.47
Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $95.41
Minimum Established Patient Price $17.4
Maximum Established Patient Price $133.76

Average Established Patient Copayment $23.85
Minimum Established Patient Copayment $4.35
Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 78.74, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

Final Score: 78.74 out of 100

The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
Quality Score: 64.17

The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability Score: 100

The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities Score: 40

The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost Score: 64.98

The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Cost Score: 64.98

The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	3	0	2	4	4	5	8	3
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	6	0	4	4	8	5	16
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 6 + 0 + 4 + 4 + 8 + 5 + 1 + 6 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 3									3

The NPI number 1730244583 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

DR. DANIELLE BEZILLA PETERSON MD

Student in an Organized Health Care Education/Training Program

999 N 92ND ST
SUITE 320
MILWAUKEE, WI
ZIP 53226

About BRETT BORDINI

Location Map

Specialty - Primary Taxonomy

Pediatrics

Insurance Plans Accepted

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Overall MIPS Quality Performance

Final Score: 78.74 out of 100

Quality Score: 64.17

Promoting Interoperability Score: 100

Improvement Activities Score: 40

Cost Score: 64.98

Cost Score: 64.98

Reviews for DR. BRETT JOHN BORDINI M.D.

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions