DR. WILLIAM A. WILMER M.D.
NPI 1750380481
Internal Medicine - Nephrology in Westerville, OH
Active since July 15, 2005PECOS EnrolledAccepts Medicare Assignment
83.63/100
CMS Quality Rating
595 COPELAND MILL RD, SUITE 2D, WESTERVILLE, OH 43081(614) 823-8500(614) 823-8501 Get Directions Write a Review
About Dr. William A. Wilmer M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. WILLIAM A. WILMER M.D. (NPI 1750380481) is an individual nephrology provider in Westerville, Ohio, licensed in Ohio (35060681) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Mount Carmel East & West, and is a graduate of University Of Toledo College Of Medicine (1988).
NPPES Registry Identity
NPI1750380481
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. WILLIAM A. WILMERCredential: M.D.
Location Address595 COPELAND MILL RD, SUITE 2DWesterville, OH 43081-8908
Mailing Address595 Copeland Mill Rd, Suite 2dWesterville, OH 43081-8908 · (614) 823-8500 · Fax (614) 823-8501
Phone(614) 823-8500
Fax(614) 823-8501
Sole ProprietorNo
Medical School CMSUniversity Of Toledo College Of MedicineGraduated 1988
Enumeration DateJuly 15, 2005
Last NPPES UpdateFebruary 14, 2022
NPPES CertifiedFebruary 14, 2022
✔ NPI 1750380481 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in OH · 35060681
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
595 COPELAND MILL RD, Westerville, OH 43081
Other Identifiers 1
Medicaid0816264OH
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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
Dr. William A. Wilmer 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 ID9638068257
PECOS Enrollment IDI20040312000134
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 11
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 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.
302 services153 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
168 services67 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
136 services65 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
106 services26 patients
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.
78 services63 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
68 services59 patients
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mount Carmel East & West
Acute Care Hospitals · Columbus, OHOwnershipVoluntary non-profit - Private
CMS Certification Number360035
Location6001 East Broad StreetColumbus, OH 43213 · Franklin County
Emergency services Birthing friendly
Genesis Hospital
Acute Care Hospitals · Zanesville, OHOwnershipVoluntary non-profit - Private
CMS Certification Number360039
Location2951 Maple AvenueZanesville, OH 43701 · Muskingum County
Emergency services Birthing friendly
Fairfield Medical Center
Acute Care Hospitals · Lancaster, OHOwnershipVoluntary non-profit - Other
CMS Certification Number360072
Location401 North Ewing StreetLancaster, OH 43130 · Fairfield County
Emergency services Birthing friendly
Ohio State University State Health System
Acute Care Hospitals · Columbus, OHOwnershipGovernment - State
CMS Certification Number360085
Location410 West 10th AvenueColumbus, OH 43210 · Franklin County
Emergency services Birthing friendly
Hocking Valley Community Hospital
Critical Access Hospitals · Logan, OHOwnershipVoluntary non-profit - Other
CMS Certification Number361330
Location601 State Route 664NLogan, OH 43138 · Hocking County
Emergency services
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 43081 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
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.
83.63/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
64.87
Improvement Activities
40
Cost
75.6
Reported Quality Measures
Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
85%1,343 patients4/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
73%37 patients4/55-star benchmark: 95%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
47%159 patients2/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
68%3,812 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
94%1,827 patients4/55-star benchmark: 100%
Patient-Generated Health Data
Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.
0%1,046 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
89%1,046 patients4/55-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
81%613 patients4/55-star benchmark: 90%
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…
99%867 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 97% · 469 patients
Patients tobacco: 96% · 469 patients
82%39 patients4/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
87%1,046 patients4/55-star benchmark: 100%
Request/Accept Summary of Care
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…
0%1,341 patients1/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
71%1,046 patients4/55-star benchmark: 75%
Send a Summary of Care
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…
10%20 patients1/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 613 patients
0%613 patients5/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
2%1,046 patients
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 6
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers33 claims2,280 services$0.30 avg. paid by Medicare
Cyclosporine, oral, 25 mg J7515
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers52 claims7,470 services$0.58 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers54 claims8,520 services$0.98 avg. paid by Medicare
Sirolimus, oral, 1 mg J7520
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers22 claims1,020 services$2.77 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
8 suppliers78 claims78 services$18.69 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
7 suppliers86 claims97 services$12.23 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 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Dentist (Pediatric Dentistry)
595 COPELAND MILL RD, SUITE 2E
WESTERVILLE, OH 43081
WESTERVILLE, OH 43081
Internal Medicine (Nephrology)
595 COPELAND MILL RD, SUITE 2D
WESTERVILLE, OH 43081
WESTERVILLE, OH 43081
Internal Medicine (Nephrology)
595 COPELAND MILL RD, SUITE 2D
WESTERVILLE, OH 43081
WESTERVILLE, OH 43081
Counselor (Professional)
595 COPELAND MILL RD, SUITE 2A
WESTERVILLE, OH 43081
WESTERVILLE, OH 43081
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 William Wilmer's NPI number?
The NPI number for William Wilmer is 1750380481. It was assigned to this individual provider in the NPPES registry on July 15, 2005.
Where is William Wilmer located?
William Wilmer practices at 595 Copeland Mill Rd Suite 2D, Westerville, OH 43081. The listed phone number is (614) 823-8500.
What is William Wilmer's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is William Wilmer enrolled in Medicare?
Yes. William Wilmer 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 William Wilmer accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list William Wilmer 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 William Wilmer affiliated with any hospitals?
According to CMS data, William Wilmer is affiliated with Mount Carmel East & West, Genesis Hospital, Fairfield Medical Center, Ohio State University State Health System and Hocking Valley Community Hospital.
When was this NPI record last updated?
The NPPES record for William Wilmer was last updated on February 14, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.
