MR. ELLIOT EDWARD CAIN PA-C
NPI 1962879551
Physician Assistant in Milwaukee, WI

NPI Status: Active since August 31, 2015

Contact Information

2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI
ZIP 53215
Phone: (414) 649-3780

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 11
Physician Assistant
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About ELLIOT CAIN

This page provides the complete NPI Profile along with additional information for Elliot Cain, a primary care provider established in Milwaukee, Wisconsin with a medical specialization in Physician Assistant and more than 11 years of experience. The healthcare provider is registered in the NPI registry with number 1962879551 assigned on August 2015. The practitioner's primary taxonomy code is 363A00000X with license number 3653-23 (WI). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI: 1962879551
Provider Name: MR. ELLIOT EDWARD CAIN PA-C
Gender: Male
Entity Type: Individual
Location Address: 2801 W KINNICKINNIC RIVER PKWY MILWAUKEE, WI 53215
Location Phone: (414) 649-3780
Mailing Address: 3301 W FOREST HOME AVE MILWAUKEE, WI 53215
Mailing Phone: (414) 389-2377
Medical School Name: OTHER
Graduation Year: 2015
Is Sole Proprietor?: No
Enumeration Date: 08-31-2015
Last Update Date: 11-29-2021
Code Navigator

A primary care provider (PCP) like Elliot Cain sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Physician Assistant
Taxonomy Code: 363A00000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: 3653-23
License State: WI
Taxonomy Description: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO

Aspirus Health Plan

HMO Bronze $0 Medical Deductible - HMO
HMO Bronze 7500 - HMO
HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
HMO Gold 1500 - HMO
HMO Gold 2400 - HMO
HMO HDHP Bronze 7200 - HMO
HMO HDHP Silver 5400 - HMO
HMO Silver 5000 - HMO
HMO Silver 6600 - HMO
POS Bronze 7500 - POS

Common Ground Healthcare Cooperative

CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
CGHC Bronze Standard $7500 - Envision Network - EPO
CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
CGHC Catastrophic $9200 - Envision Network - EPO
CGHC Gold $0 Ded - Envision Network - EPO
CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
CGHC Gold $3000 - Envision Network - EPO

HealthPartners

Robin Oak $1,000 Gold - PPO
Robin Oak $1,500 Standard Gold - PPO

Molina Healthcare

Gold 1 - HMO
Gold 1 with Adult Vision Services - HMO
Gold 8 - HMO
Silver 1 - HMO
Silver 1 with Adult Vision Services - HMO
Silver 12 with First 4 Primary Care Visits Free - HMO
Silver 8 - HMO

Quartz

QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Bronze Copay Focus (No Referrals) - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
UHC Bronze Standard (No Referrals) - HMO
UHC Bronze Value (Rx Copay, No Referrals) - HMO
UHC Bronze Value HSA (No Referrals) - HMO
UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
UHC Gold Advantage (No Referrals) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
100047807	MEDICAID (05)	WI

Medicare Participation & PECOS Enrollment Status

Elliot Cain is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Elliot Cain is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 5991012387
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20150917000864
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Coronary artery bypass using artery graft, 1 graft
Harvest of vein using an endoscope
Removal of lymph nodes of chest cavity using an endoscope

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.73 for a new patient copayment and $16.84 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53215 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $82.92
Minimum New Patient Price $53.9
Maximum New Patient Price $163.24

Average New Patient Copayment $20.73
Minimum New Patient Copayment $13.47
Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $67.37
Minimum Established Patient Price $17.4
Maximum Established Patient Price $133.76

Average Established Patient Copayment $16.84
Minimum Established Patient Copayment $4.35
Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Elliot Cain is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
AURORA ST LUKES MEDICAL CENTER	2900 W OKLAHOMA AVE MILWAUKEE, WI 53215	(414) 649-6000	Acute Care Hospitals

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	9	6	2	8	7	9	5	5	1
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	9	12	2	16	7	18	5	10
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 2 + 2 + 1 + 6 + 7 + 1 + 8 + 5 + 1 + 0 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 1									1

The NPI number 1962879551 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

DR. BERNARD J STALLER M.D.

Internal Medicine

(Cardiovascular Disease)

2801 W KINNICKINNIC RIVER PKWY
SUITE 840
MILWAUKEE, WI
ZIP 53215

About ELLIOT CAIN

Location Map

Specialty - Primary Taxonomy

Physician Assistant

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 5991012387

PECOS Enrollment ID: I20150917000864

Accepts Medicare Assignment? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

Coronary artery bypass using artery graft, 1 graft

Harvest of vein using an endoscope

Removal of lymph nodes of chest cavity using an endoscope

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Find Provider Hospital Affiliations - Privileges

Reviews for MR. ELLIOT EDWARD CAIN PA-C

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions