DR. RICHARD W THEOBALD MD
NPI 1952418063
Internal Medicine in Two Rivers, WI

Q: What is Richard Theobald's NPI number?

The NPI number for Richard Theobald is 1952418063. It was assigned to this individual provider in the NPPES registry on August 24, 2006.

Q: What is Richard Theobald's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Richard Theobald was last updated on June 3, 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.

Active since August 24, 2006PECOS EnrolledAccepts Medicare Assignment

5300 MEMORIAL DR, TWO RIVERS, WI 54241(920) 793-7300 Get Directions Write a Review

NPPES record last updated: June 3, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 3, 2024, Mar 7, 2023, Nov 29, 2021 (3 updates tracked since 2021).

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About Dr. Richard W Theobald Md NPPES

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

DR. RICHARD W THEOBALD MD (NPI 1952418063) is an individual internal medicine provider in Two Rivers, Wisconsin, licensed in Wisconsin (25728) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Manitowoc County, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (1982).

NPPES Registry Identity

NPI1952418063

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. RICHARD W THEOBALDCredential: MD

Location Address5300 MEMORIAL DRTwo Rivers, WI 54241-3923

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250

Phone(920) 793-7300

Sole ProprietorNo

Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 1982

Enumeration DateAugust 24, 2006

Last NPPES UpdateJune 3, 20243 updates tracked since enumeration

NPPES CertifiedJune 3, 2024

✔ NPI 1952418063 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 · 25728

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.

5300 MEMORIAL DR, Two Rivers, WI 54241

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Other Identifiers 1

Medicaid30645900WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners 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. Richard W Theobald Md 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 ID2860522422

PECOS Enrollment IDI20100609000370

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 17

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.

465 services304 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.

319 services82 patients

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

239 services59 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.

220 services220 patients

Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes G0473

This is a 30-minute group session focused on behavioral strategies for managing obesity. You'll join others facing similar challenges, sharing experiences and learning about nutrition, physical activity, and lifestyle changes. It's a supportive and educational environment.

159 services25 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.

134 services99 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

50 services15 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

44 services34 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

37 services37 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

35 services35 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

32 services29 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

25 services24 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

25 services24 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

23 services22 patients

Diabetes outpatient self-management training services, individual, per 30 minutes G0108

This service involves personalized training sessions, each lasting 30 minutes, to help manage diabetes. It includes guidance on monitoring blood sugar, healthy eating, physical activity, medication usage, and dealing with daily challenges of living with diabetes.

20 services11 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

14 services14 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Aurora Medical Ctr Manitowoc County

Acute Care Hospitals · Two Rivers, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number520034

Location5000 Memorial DriveTwo Rivers, WI 54241 · Manitowoc County

Emergency services Birthing friendly

Holy Family Memorial

Acute Care Hospitals · Manitowoc, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number520107

Location2300 Western AveManitowoc, WI 54221 · Manitowoc County

Emergency services

Aurora Baycare Medical Ctr

Acute Care Hospitals · Green Bay, WI

5/5 CMS rating

OwnershipProprietary

CMS Certification Number520193

Location2845 Greenbrier RdGreen Bay, WI 54311 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54241 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.

Referred Medical Equipment & Supplies CMS DME claims 12

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

12 suppliers108 claims246 services$5.35 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

9 suppliers50 claims60 services$0.83 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers11 claims11 services$46.27 avg. paid by Medicare

Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063

DME-Orthotic Devices · category DF010N

2 suppliers14 claims242 services$2.30 avg. paid by Medicare

Skin barrier, wipes or swabs, each A5120

DME-Orthotic Devices · category DF010N

3 suppliers12 claims625 services$0.23 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

2 suppliers12 claims12 services$25.07 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.

JOANNA SMOGOLESKI

Nurse Practitioner