KATHLEEN A SCHILDROTH M.D.
NPI 1902225410
Ophthalmology in Madison, WI
NPI Status: Active since April 11, 2014
Contact Information
600 HIGHLAND AVE
MADISON, WI
ZIP 53792
Phone: (608) 263-6070
Fax: (608) 263-1466
- Individual
- Female
- Years of Experience 12
- Ophthalmology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About KATHLEEN SCHILDROTH
This page provides the complete NPI Profile along with additional information for Kathleen Schildroth, a provider established in Madison, Wisconsin with a medical specialization in Ophthalmology and more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1902225410 assigned on April 2014. The practitioner's primary taxonomy code is 207W00000X with license number 69033 (WI). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1902225410
- Provider Name
- KATHLEEN A SCHILDROTH M.D.
- Other Name
- KATHLEEN A REGAN M.D.
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 600 HIGHLAND AVE MADISON, WI 53792
- Location Phone
- (608) 263-6070
- Location Fax
- (608) 263-1466
- Mailing Address
- 7974 UW HEALTH CT MIDDLETON, WI 53562
- Medical School Name
- OTHER
- Graduation Year
- 2014
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-11-2014
- Last Update Date
- 01-07-2021
- Code Navigator
Ophthalmologists like Kathleen Schildroth specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 69033
- License State
- WI
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- 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 Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- 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 Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Better Together HMO Bronze 6500 Ded/8750 MOOP HSA - HMO
- Better Together HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
- Better Together HMO Bronze No Medical Ded/10600 MOOP HSA - HMO
- Better Together HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
- Better Together HMO Gold 2000 Ded/8200 MOOP - HMO
- Better Together HMO Gold 4000 Ded/4000 MOOP HSA - HMO
- Better Together HMO Platinum 750 Ded/2000 MOOP with Vision - HMO
- Better Together HMO Platinum No Ded/3300 MOOP - HMO
- Better Together HMO Platinum No Ded/5200 MOOP - HMO
- Better Together HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
- Better Together HMO Silver 5975 Ded/5975 MOOP HSA - HMO
- Better Together HMO Silver 6000 Ded/8900 MOOP - HMO
- Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
- Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
- Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
- Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
- Partners HMO Gold 2000 Ded/8200 MOOP - HMO
- Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
- Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
- Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $700 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $700 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $8,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $9,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $8,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $9,000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
- QUARTZ ONE ACHIEVE W/GUNDERSEN BRONZE $0 MEDICAL DED - HMO
- Enrich $2,000 - 25% - HMO
- Enrich $3,500 - 30% - HMO
- Enrich $4,000 - 50% - HMO
- Enrich $5,000 HDHP - HMO
- Enrich $6,000 - 40% - HMO
- Enrich $7,500 - HMO
- Enrich $7,500 HDHP - HMO
- Enrich $9,500 - HMO
- Enrich Protection - HMO
- Premier $2,000 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,000 - 50% - HMO
- Premier $5,000 HDHP - HMO
- Premier $6,000 - 40% - HMO
- Premier $7,500 - HMO
- Premier $7,500 HDHP - HMO
- Enrich $1,500 - 30% - HMO
- Enrich $2,500 - 20% Copay - HMO
- Enrich $3,400 - 30% HDHP - HMO
- Enrich $3,500 HDHP - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Kathleen Schildroth is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Kathleen Schildroth 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
PECOS PAC ID: 1456578301
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20180622000453, I20200723000642
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.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
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
1d and 2d ultrasound scan of eye tissue and structures
2d ultrasound scan of eye tissue and structures
Cataract surgery
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Imaging of retina
Imaging of retina
Injection of drug into eye
Injection of drug into eye
Injection, aflibercept, 1 mg
Injection, bevacizumab, 10 mg
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Photography of the retina
Removal of membrane of retina
Repair of detached retina with drainage and removal of eye fluid between lens and retina
A 1D and 2D ultrasound scan of the eye is a non-invasive process that uses sound waves to create images of the eye's inner structures. This helps in detecting abnormalities or issues in the eye tissue. The procedure is safe, quick, and painless.
This service was performed 13 times for 12 patientsA 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.
This service was performed 15 times for 15 patientsCataract surgery is a procedure to remove the lens of your eye when it becomes cloudy, which is called a cataract. A synthetic lens is then inserted to restore clear vision. The operation is typically done on an outpatient basis and is very safe and effective.
This service was performed for 1-10 patientsThis 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.
This service was performed 36 times for 20 patientsThis 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.
This service was performed 286 times for 208 patientsThis 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.
This service was performed 103 times for 93 patientsImaging 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.
This service was performed 76 times for 39 patientsImaging 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.
This service was performed 659 times for 338 patientsAn 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.
This service was performed 56 times for 17 patientsAn 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.
This service was performed 401 times for 136 patientsAflibercept 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.
This service was performed 92 times for 22 patientsBevacizumab 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.
This service was performed 42 times for 19 patientsThis 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.
This service was performed 73 times for 73 patientsThis 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.
This service was performed 34 times for 34 patientsPhotography 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.
This service was performed 11 times for 11 patientsRemoval of the retina's membrane is a surgical procedure aimed at treating eye conditions affecting the retina's function. It involves a delicate operation to eliminate scar tissue or membranes causing vision problems. The procedure can help improve or stabilize vision.
This service was performed 11 times for 11 patientsThis procedure addresses a detached retina, a serious eye condition. It involves draining fluid from between the lens and retina, allowing the retina to reattach. Then, the eye fluid is removed to prevent future detachments. It's a crucial step for vision restoration.
This service was performed 15 times for 15 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.92 for a new patient copayment and $16.84 for an established patient copayment.
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 53792 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $123.69
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $30.92
- 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 99213
- Average Established Patient Price $67.37
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $16.84
- 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.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kathleen Schildroth is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| FHN MEMORIAL HOSPITAL | 1045 WEST STEPHENSON STREET FREEPORT, IL 61032 | (815) 599-6000 | Acute Care Hospitals | |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY | 600 HIGHLAND AVENUE MADISON, WI 53792 | (608) 263-6400 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1902225410, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902225410, enumerated as an "individual" on April 11, 2014.
The provider is located at 600 HIGHLAND AVE MADISON, WI 53792 and the phone number is (608) 263-6070.
Ophthalmology with taxonomy code 207W00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Group Health. Please consult your insurance carrier or call the provider to verify.
Kathleen Schildroth is affiliated with: FHN MEMORIAL HOSPITAL and UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY.
