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DR. PHILIP MICHAEL SMITH M.D.
NPI 1952351876
Ophthalmology in Minocqua, WI

Active since May 11, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
9576 HWY 70, MINOCQUA, WI 54548(715) 387-5236 Get Directions Write a Review

NPPES record last updated: April 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 25, 2024, Sep 18, 2017 (2 updates tracked since 2017).

About Dr. Philip Michael Smith M.d. NPPES

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

DR. PHILIP MICHAEL SMITH M.D. (NPI 1952351876) is an individual ophthalmology provider in Minocqua, Wisconsin, licensed in Wisconsin (53051) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Medical Center - Appleton Inc, and is a graduate of Texas Tech University Health Science Center School Of Medicine (2000).

NPPES Registry Identity

NPI1952351876
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. PHILIP MICHAEL SMITHCredential: M.D.
Location Address9576 HWY 70Minocqua, WI 54548-9067
Mailing Address1000 N Oak AveMarshfield, WI 54449-5702
Phone(715) 387-5236
Sole ProprietorNo
Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2000
Enumeration DateMay 11, 2006
Last NPPES UpdateApril 25, 20242 updates tracked since enumeration
NPPES CertifiedApril 25, 2024
✔ NPI 1952351876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in WI · 53051✔ Licensed in CA · C134021
Definition
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.
9576 HWY 70, Minocqua, WI 54548
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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, Aspirus Health Plan, Blue Cross and Blue Shield of Montana and more.Insurance ›

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

Dr. Philip Michael Smith 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 ID2567475890
PECOS Enrollment IDI20090716000450
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 10

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.

Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
270 services93 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
142 services78 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.
58 services58 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.
50 services50 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
37 services11 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
35 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520160
Location1818 N Meade StAppleton, WI 54911 · Outagamie County
Emergency services Birthing friendly

Berlin Memorial Hospital

Critical Access Hospitals · Berlin, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521355
Location225 Memorial DriveBerlin, WI 54923 · Green Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54548 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
Quality100
Promoting Interoperability97
Improvement Activities40
Cost87.2

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.

MEGAN E SIMMONS PA
Physician Assistant
9576 HWY 70
MINOCQUA, WI 54548
Oneida County (715) 358-1000
MICHAEL E M LARSON PHD
Psychologist
9576 HWY 70
MINOCQUA, WI 54548
Oneida County (715) 358-1194
JOHN BOLINGER ESTER MD
Obstetrics & Gynecology
9576 HWY 70
MINOCQUA, WI 54548
Oneida County (715) 358-1000
GRACE SCHWANTES
Pediatrics
9576 HWY 70
MINOCQUA, WI 54548
Oneida County (715) 358-1000
ABIGAIL M. MALLEK KARCH PA
Physician Assistant
9576 HWY 70
MINOCQUA, WI 54548
Oneida County (715) 358-1000
FERRY GUNAWAN MD
Hospitalist
9576 HWY 70
MINOCQUA, WI 54548
Oneida County (715) 358-1000
ROSS TAYLOR GROESCHL DPM
Podiatrist
9576 HWY 70
MINOCQUA, WI 54548
Oneida County (715) 358-1000
JAMES E TOMIC MD
Radiology (Diagnostic Radiology)
9576 HWY 70
MINOCQUA, WI 54548
Oneida County (715) 387-5511

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 Philip Smith's NPI number?

The NPI number for Philip Smith is 1952351876. It was assigned to this individual provider in the NPPES registry on May 11, 2006.

Where is Philip Smith located?

Philip Smith practices at 9576 Hwy 70, Minocqua, WI 54548. The listed phone number is (715) 387-5236.

What is Philip Smith's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Philip Smith enrolled in Medicare?

Yes. Philip Smith 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.

What insurance does Philip Smith accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Philip Smith 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 Philip Smith affiliated with any hospitals?

According to CMS data, Philip Smith is affiliated with Thedacare Regional Medical Center - Appleton Inc and Berlin Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Philip Smith was last updated on April 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.