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TODD E PAINTON
NPI 1952369647
Internal Medicine in Neenah, WI

Active since May 02, 2006PECOS EnrolledAccepts Medicare Assignment
77.77/100
CMS Quality Rating

NPPES record last updated: June 6, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Todd E Painton NPPES

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

TODD E PAINTON (NPI 1952369647) is an individual internal medicine provider in Neenah, Wisconsin, licensed in Wisconsin (41967-020) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Ne Wisconsin - St Elizabeth Campus, and is a graduate of Baylor College Of Medicine (1997).

NPPES Registry Identity

NPI1952369647
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameTODD E PAINTON
Location Address101 MAIN STNeenah, WI 54956-2570
Mailing Address101 Main StNeenah, WI 54956-2570 · (920) 727-5810
Phone(920) 727-5810
Sole ProprietorNo
Medical School CMSBaylor College Of MedicineGraduated 1997
Enumeration DateMay 2, 2006
Last NPPES UpdateJune 6, 2014
✔ NPI 1952369647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 41967-020
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
101 MAIN ST, Neenah, WI 54956
Open in Google Maps ↗

Other Identifiers 4

Medicare ID-Type Unspecified001845380WI
Medicare UPINH12047WI
Medicaid32625600WI
Medicare ID-Type Unspecified002160015WI

Accepted Insurance

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

Todd E Painton 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 ID2466449392
PECOS Enrollment IDI20040430000457
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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
224 services140 patients
Anticoagulant management of patient taking warfarin 93793
Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.
182 services13 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.
126 services87 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
106 services106 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.
67 services55 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
28 services24 patients

Hospital Affiliations CMS Care Compare 2

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

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520045
Location130 2nd StNeenah, WI 54956 · Winnebago County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54956 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.

77.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.47
Promoting Interoperability77
Improvement Activities40
Cost63.8

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
74%301 patients4/55-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)…
58%234 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
81%859 patients4/55-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: 65% · 26 patients
Patients 4MonthsOfStart: 29% · 35 patients
23%30 patients
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
58%228 patients3/55-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.
98%8,565 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
43%345 patients2/55-star benchmark: 88%
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%233 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.
96%1,644 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
86%1,612 patients4/55-star benchmark: 97%
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…
76%1,643 patients4/55-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…
28%1,643 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.
32%1,643 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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers32 claims90 services$6.03 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
1 supplier12 claims2,400 services$1.68 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 18

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

STEPHEN T CRUZ MD
Family Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-5810
MARK D MOHR MD
Internal Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-5810
KELSEY KIENERT M.D.
Internal Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 720-1463
TOMASZ K MIASKOWSKI MD
Family Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-5810
WILLIAM L NELSON MD
Internal Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-4220
ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC
Clinic/Center (Multi-Specialty)
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-4200
NICOLE VER VOORT APNP
Nurse Practitioner
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 720-1463
JAMES R BURNS MD
Internal Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-4220

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 Todd Painton's NPI number?

The NPI number for Todd Painton is 1952369647. It was assigned to this individual provider in the NPPES registry on May 2, 2006.

Where is Todd Painton located?

Todd Painton practices at 101 Main St, Neenah, WI 54956. The listed phone number is (920) 727-5810.

What is Todd Painton's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Todd Painton enrolled in Medicare?

Yes. Todd Painton 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 Todd Painton accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Todd Painton 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 Todd Painton affiliated with any hospitals?

According to CMS data, Todd Painton is affiliated with Ascension NE Wisconsin - St Elizabeth Campus and Thedacare Regional Med Ctr - Neenah.

When was this NPI record last updated?

The NPPES record for Todd Painton was last updated on June 6, 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.