NICHOLAS H. TOSI MD
NPI 1891924650
Ophthalmology - Retina Specialist in Milwaukee, WI

Q: What is Nicholas Tosi's NPI number?

The NPI number for Nicholas Tosi is 1891924650. It was assigned to this individual provider in the NPPES registry on July 14, 2009.

Q: What is Nicholas Tosi's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Tosi was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 14, 2009PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

2600 N MAYFAIR RD STE 901, MILWAUKEE, WI 53226(414) 774-3484(414) 778-3446 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 7, 2023, Jun 23, 2021, May 14, 2021 and 2 more (5 updates tracked since 2019).

On this page

About Nicholas H. Tosi Md NPPES

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

NICHOLAS H. TOSI MD (NPI 1891924650) is an individual retina specialist in Milwaukee, Wisconsin, licensed in Wisconsin (63729) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Aurora St Lukes Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1891924650

Entity TypeIndividualMale

Primary Taxonomy207WX0107X

Provider Legal NameNICHOLAS H. TOSICredential: MD

Location Address2600 N MAYFAIR RD STE 901Milwaukee, WI 53226-1307

Mailing Address2600 N Mayfair Rd Ste 901Milwaukee, WI 53226-1307 · (414) 774-3484 · Fax (414) 778-3446

Phone(414) 774-3484

Fax(414) 778-3446

Sole ProprietorNo

Medical School CMSClvlnd Clinic Lerner College Of Med Of Case Wstn Rsv UniversityGraduated 2009

Enumeration DateJuly 14, 2009

Last NPPES UpdateMarch 7, 20235 updates tracked since enumeration

NPPES CertifiedJune 23, 2021

✔ NPI 1891924650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians

Taxonomy Code207WX0107X

License✔ Licensed in WI · 63729

Definition

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Also ListedOphthalmologyTaxonomy 207W00000X · License 63729 (WI)

2600 N MAYFAIR RD STE 901, Milwaukee, WI 53226

Open in Google Maps ↗

Secondary Practice Locations 3

Location 11111 Delafield St Ste 227Waukesha, WI 53188-3400 · Phone (262) 524-9215

Location 26815 118th AveKenosha, WI 53142-8420 · Phone (262) 857-5650

Location 32801 W Kinnickinnic River Pkwy Ste 350Milwaukee, WI 53215-3695 · Phone (414) 649-4660

Other Identifiers 5

Other12552288Caqh

Other63729WI · State License

Other883853American Academy Of Ophthalmology

Medicaid100044825WI

Other32397American Board Of Ophthalmology

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health 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

Nicholas H. Tosi 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 ID5092957928

PECOS Enrollment IDI20150611000046

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 Reassignment

Medicare enrollment records show Nicholas Tosi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Retina & Vitreous Consultants Of Wi, Ltd.

Same address

Retina Specialist

2600 N MAYFAIR RD, SUITE 901
Milwaukee, WI 53226

Reassigned Medicare billing, Wisconsin enrollment
5 clinicians in this Medicare group

NPI 1114044435 (414) 774-3484

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 18

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.

Injection, faricimab-svoa, 0.1 mg J2777

Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.

58,099 services116 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

4,341 services1,059 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

3,778 services305 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

3,705 services630 patients

Injection, bevacizumab, 10 mg J9035

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

1,483 services307 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.

1,333 services870 patients

Injection, ranibizumab, 0.1 mg J2778

Ranibizumab is a medication given via injection to treat certain eye conditions like age-related macular degeneration. It works by slowing vision loss and in some cases, improving vision by blocking abnormal blood vessel growth in the eye.

549 services22 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

412 services21 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

157 services157 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.

119 services100 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

108 services108 patients

Exam of retinal blood vessels using a special camera after injection of a dye 92235

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

91 services90 patients

Removal of membrane of retina with removal of internal limiting membrane of retina 67042

This procedure involves the surgical removal of a thin layer, called the membrane, from the retina. It also includes the removal of the innermost layer of the retina, known as the internal limiting membrane. This can help improve vision.

40 services39 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

35 services25 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

19 services19 patients

Destruction of leaking blood vessels of retina using laser 67228

This procedure involves using a laser to treat leaking blood vessels in the retina, the part of the eye responsible for vision. The laser seals off these vessels, preventing further leakage and helping to preserve sight.

17 services12 patients

Extended exam of the back part of the eye with retinal drawing 92201

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

16 services14 patients

Photocoagulation treatment to prevent detachment of retina 67145

Photocoagulation is a procedure used to treat retinal disorders. A special laser is directed at the retina to create small burns. These burns form scar tissue which helps to secure the retina to the eye's wall, preventing detachment and preserving vision.

14 services13 patients

Hospital Affiliations CMS Care Compare

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

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520138

Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Reported Quality Measures

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

100%92 patients5/55-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

83%650 patients4/55-star benchmark: 100%

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.

Other Providers at the Same Location NPPES 4

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

LINCOLN SHAW

Ophthalmology (Retina Specialist)

2600 N MAYFAIR RD STE 901
MILWAUKEE, WI 53226

Milwaukee County (773) 702-3937

DR. KEVIN FRANCIS ELWOOD MD

Ophthalmology (Retina Specialist)

2600 N MAYFAIR RD STE 901
MILWAUKEE, WI 53226

Milwaukee County (414) 774-3484

DR. RAZEK GEORGES COUSSA MDCM, MPHIL, MENG

Ophthalmology (Retina Specialist)

2600 N MAYFAIR RD STE 901
MILWAUKEE, WI 53226

Milwaukee County (414) 774-3484

DR. JONATHAN M HERSHEY M.D.

Ophthalmology (Retina Specialist)

2600 N MAYFAIR RD STE 901
MILWAUKEE, WI 53226

Milwaukee County (414) 774-3484

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 Nicholas Tosi's NPI number?

The NPI number for Nicholas Tosi is 1891924650. It was assigned to this individual provider in the NPPES registry on July 14, 2009.

Where is Nicholas Tosi located?

Nicholas Tosi practices at 2600 N Mayfair Rd Ste 901, Milwaukee, WI 53226. The listed phone number is (414) 774-3484.

What is Nicholas Tosi's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Nicholas Tosi enrolled in Medicare?

Yes. Nicholas Tosi 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 organization bills Medicare for Nicholas Tosi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Tosi reassigns Medicare benefits to Retina & Vitreous Consultants Of Wi, Ltd. (Milwaukee, WI). The 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 Nicholas Tosi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicholas Tosi accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and CareSource (Common Ground Healthcare) and 4 other insurers list Nicholas Tosi 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 Nicholas Tosi affiliated with any hospitals?

According to CMS data, Nicholas Tosi is affiliated with Aurora St Lukes Medical Center.

When was this NPI record last updated?

The NPPES record for Nicholas Tosi was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.