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GREGORY M. CULEN M.D.
NPI 1912937947
Hospitalist in Racine, WI

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment
3807 SPRING ST, RACINE, WI 53405(262) 687-8300 Get Directions Write a Review

NPPES record last updated: August 22, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Gregory M. Culen M.d. NPPES

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

GREGORY M. CULEN M.D. (NPI 1912937947) is an individual hospitalist provider in Racine, Wisconsin, licensed in Wisconsin (42223-20) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and is a graduate of Rush Medical College Of Rush University (1997).

NPPES Registry Identity

NPI1912937947
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameGREGORY M. CULENCredential: M.D.
Location Address3807 SPRING STRacine, WI 53405-1667
Mailing Address3807 Spring StRacine, WI 53405-1667 · (262) 687-8300
Phone(262) 687-8300
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 1997
Enumeration DateJuly 4, 2006
Last NPPES UpdateAugust 22, 2023
NPPES CertifiedAugust 22, 2023
✔ NPI 1912937947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in WI · 42223-20
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 42223 (WI)
3807 SPRING ST, Racine, WI 53405
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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

Gregory M. Culen 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 ID9133222771
PECOS Enrollment IDI20070320000108
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 5

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.

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.
541 services204 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.
245 services117 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
148 services141 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
110 services106 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 services66 patients

Hospital Affiliations CMS Care Compare

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

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI
1/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number520021
Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53405 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
$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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%182 patients5/55-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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers43 claims43 services$15.10 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers44 claims44 services$70.10 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.

JEFFREY NAUS MD
Pediatrics
3807 SPRING ST
RACINE, WI 53405
Racine County (262) 687-8282
CAMILLE A. PAQUETTE-SCHULGIT M.D.
Family Medicine
3807 SPRING ST
RACINE, WI 53405
Racine County (262) 687-8173
LESLEY DELGADO M.D.
Pediatrics
3807 SPRING ST
MOUNT PLEASANT, WI 53405
Racine County (262) 687-8282
SACHIN H. PANCHAL M.D.
Internal Medicine
3807 SPRING ST
MOUNT PLEASANT, WI 53405
Racine County (262) 687-4011
MS. LINDA M THOMSON RPH
Pharmacist
3807 SPRING ST
RACINE, WI 53405
Racine County (262) 687-8430
ASCENSION ALL SAINTS HOSPITAL, INC
Pharmacy (Community/Retail Pharmacy)
3807 SPRING ST
MOUNT PLEASANT, WI 53405
Racine County (262) 687-8430
LESLIE M HERTZ MD
Pediatrics
3807 SPRING ST
RACINE, WI 53405
Racine County (262) 687-8282
KYLIE S NORDNESS PA-C
Physician Assistant
3807 SPRING ST
RACINE, WI 53405
Racine County (262) 687-8173

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 Gregory Culen's NPI number?

The NPI number for Gregory Culen is 1912937947. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Gregory Culen located?

Gregory Culen practices at 3807 Spring St, Racine, WI 53405. The listed phone number is (262) 687-8300.

What is Gregory Culen's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Gregory Culen enrolled in Medicare?

Yes. Gregory Culen 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.

Is Gregory Culen affiliated with any hospitals?

According to CMS data, Gregory Culen is affiliated with Froedtert South Inc..

When was this NPI record last updated?

The NPPES record for Gregory Culen was last updated on August 22, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.