RICHARD S VANDER HEIDE MD, PH.D.
NPI 1639116148
Pathology - Cytopathology in Marshfield, WI


Quality Rating: 83.37 out of 100 score

NPI Status: Active since June 01, 2006

Contact Information

1000 N OAK AVE
MARSHFIELD, WI
ZIP 54449
Phone: (715) 387-5511

Get Directions Reviews

  • Individual
  • Male
  • Pathology
  • Cytopathology
  • Accepts Insurance
  • PECOS Enrolled

About RICHARD VANDER HEIDE

This page provides the complete NPI Profile along with additional information for Richard Vander Heide, a provider established in Marshfield, Wisconsin with a medical specialization in Pathology, focusing in cytopathology . The healthcare provider is registered in the NPI registry with number 1639116148 assigned on June 2006. The practitioner's primary taxonomy code is 207ZC0500X with license number 76229 (WI). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1639116148
Provider Name
RICHARD S VANDER HEIDE MD, PH.D.
Gender
Male
Entity Type
Individual
Location Address
1000 N OAK AVE MARSHFIELD, WI 54449
Location Phone
(715) 387-5511
Mailing Address
1000 N OAK AVE MARSHFIELD, WI 54449
Is Sole Proprietor?
No
Enumeration Date
06-01-2006
Last Update Date
08-22-2024
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Location Map

Secondary Locations

  • 4646 John R St
    Detroit, MI 48201
    (313) 576-3610

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

Pathology Cytopathology

Taxonomy Code
207ZC0500X
Type
Allopathic & Osteopathic Physicians
License No.
76229
License State
WI
Taxonomy Description
A cytopathologist is an anatomic pathologist trained in the diagnosis of human disease by means of the study of cells obtained from body secretions and fluids, by scraping, washing, or sponging the surface of a lesion, or by the aspiration of a tumor mass or body organ with a fine needle. A major aspect of a cytopathologist's practice is the interpretation of Papanicolaou-stained smears of cells from the female reproductive systems, the Pap test. However, the cytopathologist's expertise is applied to the diagnosis of cells from all systems and areas of the body. He/she is a consultant to all medical specialists.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207ZC0006XAllopathic & Osteopathic Physicians

Pathology
Clinical Pathology

76229 (WI)
2207ZP0102XAllopathic & Osteopathic Physicians

Pathology
Anatomic Pathology & Clinical Pathology

4301062679 (MI)

Insurance Plans Accepted

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

  • Bronze First - HMO
  • Bronze First Adult Vision & Fitness - HMO
  • Diabetes Gold - HMO
  • Diabetes Gold Adult Vision & Fitness - HMO
  • Diabetes Silver - HMO
  • Diabetes Silver Adult Vision & Fitness - HMO
  • Gold - HMO
  • Gold Adult Vision & Fitness - HMO
  • HDHP Preventive Silver - HMO
  • Healthy Heart Gold - HMO
  • Healthy Heart Gold Adult Vision & Fitness - HMO
  • Healthy Heart Silver - HMO
  • Healthy Heart Silver Adult Vision & Fitness - HMO
  • Low Premium Silver - HMO
  • Low Premium Silver Adult Vision & Fitness - HMO
  • Silver - HMO
  • Silver Adult Vision & Fitness - HMO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze HSA - EPO
  • Medica Individual Choice Bronze Share - EPO
  • Medica Individual Choice Bronze Share - HMO
  • Medica Individual Choice Expanded Bronze Standard - EPO
  • Medica Individual Choice Expanded Bronze Standard - HMO
  • Medica Individual Choice Gold $0 Copay PCP Visits - EPO
  • Medica Individual Choice Gold $0 Copay PCP Visits - HMO
  • Medica Individual Choice Gold Share - EPO
  • Medica Individual Choice Gold Share - HMO
  • Medica Individual Choice Gold Standard - EPO
  • Medica Individual Choice Gold Standard - HMO
  • Medica Individual Choice Silver $0 Copay PCP Visits - EPO
  • Medica Individual Choice Silver $0 Copay PCP Visits - HMO
  • Medica Individual Choice Silver Share - EPO
  • Medica Individual Choice Silver Share - HMO
  • Medica Individual Choice Silver Standard - EPO
  • Medica Individual Choice Silver Standard - HMO
  • 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

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

Medicare Participation & PECOS Enrollment Status

Richard Vander Heide 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

  • 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

Physician Visit Costs

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 54449 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $123.69
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $30.92
  • 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 99214

  • Average Established Patient Price $95.41
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $23.85
  • 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.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 83.37, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 83.37 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 82.77

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 67.75

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 67.75

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Reviews for RICHARD S VANDER HEIDE MD, PH.D.

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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.
1639116148
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2669211218
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 6 + 9 + 2 + 1 + 1 + 2 + 1 + 8 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1639116148 is valid because the calculated check digit 8 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.

NPI Name / Type Taxonomy Address
1982693883 KRISTEN JEAN RASMUSSEN M.S.
Individual
Genetic Counselor, MS1000 N OAK AVE MARSHFIELD CLINIC; 3C1
MARSHFIELD, WI 54449
(715) 221-7408
1275522971 CHRISTINA ANN ZALESKI M.S.
Individual
Genetic Counselor, MS1000 N OAK AVE 3C1
MARSHFIELD, WI 54449
(715) 221-7407
1588653117 CARRIE A ZABEL M.S.
Individual
Genetic Counselor, MS1000 N OAK AVE DEPT OF MEDICAL GENETICS - 3C1
MARSHFIELD, WI 54449
(715) 221-7400
1538144282 LEA K LUA MD
Individual
Pediatrics (Pediatric Critical Care Medicine)1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5511
1942274352 NARAYANA S MURALI MD
Individual
Internal Medicine (Nephrology)1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5511
1538190376 KATHLEEN A CYPHER MSSW
Individual
Social Worker1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5511
1225060890 BOYD EARL VOMOCIL M.D.
Individual
Nuclear Medicine (Nuclear Imaging & Therapy)1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5511
1477587889 L REBECCA CAMPBELL MD
Individual
Psychiatry & Neurology (Neurology)1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5511
1467487058 JULIE A BERGER MS CCCA
Individual
Audiologist1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5511
1710907142 DONNA PROHAZKA MD
Individual
Radiology (Diagnostic Radiology)1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5511
1841304771 ANNE R. MATTSON MS CCC-SLP
Individual
Speech-Language Pathologist1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5511
1053426528 DOUGLAS J WOOD MS CCCA
Individual
Audiologist1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5371
1316052889 HAROLD WERTH PA
Individual
Physician Assistant1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5235
1760597231 ROBERT RENNELLS PA
Individual
Physician Assistant1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5235
1417062936 JAMES A HOLZBERGER MD
Individual
Ophthalmology1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 221-7572
1477668994 RICHARD B PATCHETT MD
Individual
Ophthalmology1000 N OAK AVE
MARSHFIELD, WI 54449
(713) 387-9371
1477668903 ELLEN M GORDON MD
Individual
Dermatology1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-9269
1891800322 STELLA FRUNZA PATTEN MD
Individual
Dermatology1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-9460
1902912439 DENNIS R ANDERSON MD
Individual
Ophthalmology1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 389-4027
1437264991 KATHARINE HOBART ODELL PHD, CCC-SLP
Individual
Speech-Language Pathologist1000 N OAK AVE
MARSHFIELD, WI 54449
(715) 387-5128

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639116148, enumerated in the NPI registry as an "individual" on June 01, 2006

The provider is located at 1000 N Oak Ave Marshfield, Wi 54449 and the phone number is (715) 387-5511

The provider's speciality is Pathology with taxonomy code 207ZC0500X with a focus in Cytopathology

The provider might be accepting Accepts: HAP CareSource, Medica and Molina Healthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

Medicare beneficiaries should expect a typical cost of $123.69 with an average copayment of $30.92 for new patient appointments. Established patients should expect a typical charge of $95.41 and an average copayment of 23.85. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on June 01, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.