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CHARLES R SPELICH D.O.
NPI 1811334675
Family Medicine in Milwaukee, WI

Active since June 03, 2013PECOS EnrolledAccepts Medicare Assignment
75.75/100
CMS Quality Rating
2311 N PROSPECT AVE, MILWAUKEE, WI 53211(414) 319-3000(414) 319-3033 Get Directions Write a Review

NPPES record last updated: October 31, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Charles R Spelich D.o. NPPES

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

CHARLES R SPELICH D.O. (NPI 1811334675) is an individual family medicine provider in Milwaukee, Wisconsin, licensed in Wisconsin (68209) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2013).

NPPES Registry Identity

NPI1811334675
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameCHARLES R SPELICHCredential: D.O.
Location Address2311 N PROSPECT AVEMilwaukee, WI 53211-4445
Mailing Address2311 N Prospect AveMilwaukee, WI 53211-4445 · (414) 319-3000 · Fax (414) 319-3033
Phone(414) 319-3000
Fax(414) 319-3033
Sole ProprietorNo
Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 2013
Enumeration DateJune 3, 2013
Last NPPES UpdateOctober 31, 2017
✔ NPI 1811334675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 68209
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2311 N PROSPECT AVE, Milwaukee, WI 53211
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Accepted Insurance

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

Charles R Spelich D.o. 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 ID8921221888
PECOS Enrollment IDI20171117002413
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 Charles Spelich reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Columbia St. Mary's Hospital Milwaukee Inc
0.2 mi
Multi-Specialty
2323 N LAKE DR
Milwaukee, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Columbia St Marys Hospital Milwaukee Inc
  • 856 clinicians in this Medicare group
NPI 1225071491 (414) 585-1000
Ascension Medical Group-Southeast Wisconsin Inc
0.2 mi
Anesthesiology
2301 N LAKE DR
Milwaukee, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,343 clinicians in this Medicare group
NPI 1194473066 (414) 585-1000

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

Areas of Expertise CMS Part B claims 3

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.
96 services55 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
41 services41 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.
25 services23 patients

Hospital Affiliations CMS Care Compare 3

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

Ascension Columbia St Mary's Hospital Milwaukee

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520051
Location2323 N Lake DrMilwaukee, WI 53211 · Milwaukee County
Emergency services Birthing friendly

Ascension SE Wisconsin Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520136
Location5000 W Chambers StMilwaukee, WI 53210 · Milwaukee County
Emergency services Birthing friendly

Orthopaedic Hospital Of Wisconsin

Acute Care Hospitals · Glendale, WI
OwnershipPhysician
CMS Certification Number520194
Location475 W River Woods PkwyGlendale, WI 53212 · Milwaukee County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53211 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

75.75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.16
Promoting Interoperability76
Improvement Activities40
Cost57.63

Referred Medical Equipment & Supplies CMS DME claims

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers13 claims38 services$5.91 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.

DR. MARY GRACE HERNANDEZ LASQUETY M.D.
Family Medicine
2311 N PROSPECT AVE
MILWAUKEE, WI 53211
Milwaukee County (414) 319-3000
DR. PEDRO M. BANDA MD
Urology
2311 N PROSPECT AVE
MILWAUKEE, WI 53211
Milwaukee County (414) 319-3000
DR. TAMARA A ADDUCCI MD
Obstetrics & Gynecology
2311 N PROSPECT AVE
MILWAUKEE, WI 53211
Milwaukee County (414) 319-3000
MS. MICHELLE BARCELONA FNP
Nurse Practitioner (Family)
2311 N PROSPECT AVE
MILWAUKEE, WI 53211
Milwaukee County (414) 319-3000
DR. DAVID S. SANDOCK MD
Urology
2311 N PROSPECT AVE
MILWAUKEE, WI 53211
Milwaukee County (414) 319-3000
DR. MAURICE WENDELL CHUNG M.D.
Internal Medicine (Gastroenterology)
2311 N PROSPECT AVE
MILWAUKEE, WI 53211
Milwaukee County (414) 319-3000
SALOMON COHEN COHEN MD
Neurological Surgery
2311 N PROSPECT AVE
MILWAUKEE, WI 53211
Milwaukee County (414) 319-3000
LINDA P PEREZ APNP
Nurse Practitioner (Family)
2311 N PROSPECT AVE
MILWAUKEE, WI 53211
Milwaukee County (414) 319-3000

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 Charles Spelich's NPI number?

The NPI number for Charles Spelich is 1811334675. It was assigned to this individual provider in the NPPES registry on June 3, 2013.

Where is Charles Spelich located?

Charles Spelich practices at 2311 N Prospect Ave, Milwaukee, WI 53211. The listed phone number is (414) 319-3000.

What is Charles Spelich's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Charles Spelich enrolled in Medicare?

Yes. Charles Spelich 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 Charles Spelich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Spelich reassigns Medicare benefits to 2 organizations: Columbia St. Mary's Hospital Milwaukee Inc (Milwaukee, WI) and Ascension Medical Group-Southeast 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 Charles Spelich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Charles Spelich accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Charles Spelich 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 Charles Spelich affiliated with any hospitals?

According to CMS data, Charles Spelich is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, Ascension SE Wisconsin Hospital and Orthopaedic Hospital Of Wisconsin.

When was this NPI record last updated?

The NPPES record for Charles Spelich was last updated on October 31, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.