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DR. THOMAS ROBERT ROWELL M.D..
NPI 1942413513
Psychiatry & Neurology - Psychiatry in Appleton, WI

Active since May 08, 2007PECOS EnrolledAccepts Medicare Assignment
95.81/100
CMS Quality Rating
1531 S MADISON ST, SUITE 580, APPLETON, WI 54915(920) 475-3711 Get Directions Write a Review

NPPES record last updated: January 2, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Thomas Robert Rowell M.d.. NPPES

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

DR. THOMAS ROBERT ROWELL M.D.. (NPI 1942413513) is an individual psychiatry provider in Appleton, Wisconsin, licensed in Wisconsin (55693020) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Ascension Ne Wisconsin - St Elizabeth Campus, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1942413513
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. THOMAS ROBERT ROWELLCredential: M.D..
Location Address1531 S MADISON ST, SUITE 580Appleton, WI 54915-1800
Mailing Address1531 S Madison St, Suite 580Appleton, WI 54915-1800 · (920) 636-5510
Phone(920) 475-3711
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateMay 8, 2007
Last NPPES UpdateJanuary 2, 2014
✔ NPI 1942413513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in WI · 55693020✔ Licensed in VA · 0101242091
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1531 S MADISON ST, Appleton, WI 54915
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Other Identifiers 9

Medicare UPIN1942413513WI
Medicare NSC1942413513VA
Medicaid1942413513WI
Medicare OSCAR/certification1942413513VA
Medicare PIN1942413513WI
Medicare NSC1942413513WI
Medicare UPIN1942413513
Medicaid1942413513VA
Medicare PIN1942413513

Accepted Insurance

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

Dr. Thomas Robert Rowell 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 ID7416032560
PECOS Enrollment IDI20110608000566
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 Thomas Rowell reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ascension NE Wisconsin, Inc
Same address
General Acute Care Hospital
1506 S ONEIDA ST
Appleton, WI 54915
  • Reassigned Medicare billing, Wisconsin enrollment
  • 194 clinicians in this Medicare group
NPI 1407803638 (920) 738-2000
Ascension Medical Group-Fox Valley Wisconsin, Inc
5.2 mi
Multi-Specialty
101 MAIN ST
Neenah, WI 54956
  • Reassigned Medicare billing, Wisconsin enrollment
  • 444 clinicians in this Medicare group
NPI 1730126392 (920) 727-4200

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 8

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.
75 services37 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
36 services23 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.
31 services16 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.
26 services25 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.
23 services11 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.
17 services15 patients

Hospital Affiliations CMS Care Compare

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

Ascension NE Wisconsin - St Elizabeth Campus

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520009
Location1506 S Oneida StAppleton, WI 54915 · Outagamie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54915 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
$163.24 typical visit price
range $53.90 – $163.24
Typical copayment $40.81 (range $13.47 – $40.81)
Most-billed visit code 99205
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.

95.81/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability81
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
44%95 patients2/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
35%211 patients
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
13%23 patients1/55-star benchmark: 95%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
53%158 patients3/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 9% · 81 patients
Patients 4MonthsOfStart: 4% · 104 patients
14%92 patients
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.
100%1,204 patients5/55-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.
95%4,626 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%50 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
57%789 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
10%100 patients1/55-star benchmark: 96%
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: 98% · 289 patients
Patients tobacco: 18% · 91 patients
71%289 patients3/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
70%788 patients3/55-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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
22%788 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
27%788 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.

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.

KAILIE BECK ANPN, FNP-C
Nurse Practitioner (Family)
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 738-2000
MS. MICHELLE KENNEDY COENEN MS
Social Worker (Clinical)
1531 S MADISON ST, STE 550
APPLETON, WI 54915
Calumet County (920) 738-2700
ANNEMARIE UPHUS APNP, PMHNP-BC, CNM
Nurse Practitioner
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 730-4411
DEBRA L. FRANCIOSI APNP
Nurse Practitioner (Psychiatric/Mental Health)
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 730-4411
JENNIFER L CASTRO SAC
Counselor (Addiction (Substance Use Disorder))
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 831-8437
THOMAS G HOEFT D.O.
Orthopaedic Surgery
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 996-3700
CHRISTOPHER W WAGENER MD
Obstetrics & Gynecology
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 730-4413
DR. LEE W HASH M.D.
Orthopaedic Surgery
1531 S MADISON ST
APPLETON, WI 54915
Calumet County (920) 996-3700

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 Thomas Rowell's NPI number?

The NPI number for Thomas Rowell is 1942413513. It was assigned to this individual provider in the NPPES registry on May 8, 2007.

Where is Thomas Rowell located?

Thomas Rowell practices at 1531 S Madison St Suite 580, Appleton, WI 54915. The listed phone number is (920) 475-3711.

What is Thomas Rowell's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Thomas Rowell enrolled in Medicare?

Yes. Thomas Rowell 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 Thomas Rowell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Rowell reassigns Medicare benefits to 2 organizations: Ascension NE Wisconsin, Inc (Appleton, WI) and Ascension Medical Group-Fox Valley Wisconsin, Inc (Neenah, 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 Thomas Rowell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Rowell accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, Network Health and Security Health Plan list Thomas Rowell 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 Thomas Rowell affiliated with any hospitals?

According to CMS data, Thomas Rowell is affiliated with Ascension NE Wisconsin - St Elizabeth Campus.

When was this NPI record last updated?

The NPPES record for Thomas Rowell was last updated on January 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.