Active NPI 1346204757 Individual Practitioner Male Practitioner

Dr. John Dominic Decarlo , MD

Ophthalmology • Brookfield, WI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. John Decarlo, MD is a certified Ophthalmology practicing in Brookfield, WI. With approximately 52 years of clinical experience since graduating from Loyola University Of Chicago, Stritch School Of Medicine in 1974, Dr. Decarlo delivers high-quality medical care to the local community at 16650 W BLUEMOUND RD # 400B.

Dr. Decarlo accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, imaging of optic nerve, imaging of retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

16650 W Bluemound Rd # 400b

Brookfield, WI 530055920

Telephone 4144765120

Fax 4144765181

Associated Practice Facility / Clinic

🏢 Kw Surgical Services Sc Facility NPI 1336846641

Medicare Profile & Education

Medical School

Loyola University Of Chicago, Stritch School Of Medicine

Graduation Year

1974

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Brookfield, WI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

52 Yrs +21.0 yrs vs City Avg

City Avg: 31.0 Yrs

State Avg: 25.3 Yrs

Regional Practice Density

6 Specialists

Practicing in Brookfield, WI (464 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

63.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Decarlo (52 Years) 52 Yrs

Brookfield Specialty Average (31.0 Years) 31.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	214	208	$244.00	$120.53
99213 Established patient office or other outpatient visit, typically 15 minutes	62	51	$178.00	$85.36
92133 Imaging of optic nerve	21	20	$208.00	$34.27
92134 Imaging of retina	15	15	$192.00	$38.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$214.00	$104.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	224	218	$244.00	$120.77
99213 Established patient office or other outpatient visit, typically 15 minutes	86	66	$178.00	$85.13
92134 Imaging of retina	25	23	$192.00	$38.44
92133 Imaging of optic nerve	22	21	$208.00	$34.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$214.00	$104.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	236	232	$244.00	$122.38
99213 Established patient office or other outpatient visit, typically 15 minutes	132	97	$178.50	$86.05
92134 Imaging of retina	38	38	$192.00	$38.84
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	30	30	$214.00	$106.06
66984 Removal of cataract with insertion of lens	19	16	$5394.00	$511.43
99202 New patient office or other outpatient visit, typically 20 minutes	19	19	$148.00	$68.92
92133 Imaging of optic nerve	19	16	$208.00	$32.93
76519 Ultrasound of eye for determination of lens power	17	17	$430.00	$54.19
66821 Removal of recurring cataract in lens capsule using a laser	14	14	$1950.00	$292.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	280	275	$244.00	$125.37
99213 Established patient office or other outpatient visit, typically 15 minutes	133	101	$178.50	$87.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	32	32	$214.00	$107.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	14	$106.55	$54.40
66984 Removal of cataract with insertion of lens	28	22	$5394.00	$525.18
92134 Imaging of retina	25	23	$192.00	$39.94
99202 New patient office or other outpatient visit, typically 20 minutes	22	22	$148.00	$70.19
76519 Ultrasound of eye for determination of lens power	21	21	$430.00	$57.23
92083 Exam of visual field with extended testing	19	18	$186.00	$61.57
92133 Imaging of optic nerve	14	14	$208.00	$35.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	296	292	$244.00	$105.97
99213 Established patient office or other outpatient visit, typically 15 minutes	133	98	$178.00	$72.54
92134 Imaging of retina	51	49	$192.00	$40.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	46	46	$214.00	$104.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	15	$104.00	$41.53
92133 Imaging of optic nerve	21	19	$208.00	$36.39
76519 Ultrasound of eye for determination of lens power	16	15	$430.00	$54.72
66984 Removal of cataract with insertion of lens	12	11	$5394.00	$512.52
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$148.00	$73.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	407	396	$243.93	$105.11
99213 Established patient office or other outpatient visit, typically 15 minutes	228	160	$178.00	$71.21
92134 Imaging of retina	42	41	$192.00	$40.11
66984 Removal of cataract with insertion of lens	40	35	$5394.00	$615.71
92133 Imaging of optic nerve	34	33	$208.00	$35.84
76519 Ultrasound of eye for determination of lens power	34	29	$430.00	$53.82
99202 New patient office or other outpatient visit, typically 20 minutes	28	28	$148.00	$73.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$214.00	$103.98
66821 Removal of recurring cataract in lens capsule using a laser	14	14	$2089.29	$307.99
92083 Exam of visual field with extended testing	13	13	$186.00	$62.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	504	493	$243.88	$100.02
99213 Established patient office or other outpatient visit, typically 15 minutes	256	174	$178.00	$67.88
66984 Removal of cataract with insertion of lens	51	44	$5394.00	$593.82
92134 Imaging of retina	48	47	$192.00	$38.97
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	45	45	$214.00	$99.72
76519 Ultrasound of eye for determination of lens power	39	36	$430.00	$52.57
92133 Imaging of optic nerve	35	34	$208.00	$35.18
99202 New patient office or other outpatient visit, typically 20 minutes	34	34	$148.00	$69.65
92083 Exam of visual field with extended testing	17	16	$186.00	$60.28
66821 Removal of recurring cataract in lens capsule using a laser	15	15	$1950.00	$291.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	688	587	$244.00	$102.96
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	118	118	$214.00	$101.92
99213 Established patient office or other outpatient visit, typically 15 minutes	100	90	$178.00	$70.02
76519 Ultrasound of eye for determination of lens power	88	72	$430.00	$64.23
66984 Removal of cataract with insertion of lens	76	59	$5394.00	$606.83
92083 Exam of visual field with extended testing	30	28	$186.00	$62.00
92133 Imaging of optic nerve	23	22	$208.00	$35.83
92134 Imaging of retina	13	13	$192.00	$39.56

Medical Specialties & State Licenses

CMS Verified: 2024-02-19

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License WI 21652-020

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

30261600 (WI)

Commercial Insurance / Payer ID Blue Cross Blue Shield

391382883015 (WI)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location February 19, 2024

Registered at 16650 W BLUEMOUND RD # 400B, BROOKFIELD, WI 530055920 (Tel: 4144765120)

📍

Updated Business Mailing Address February 19, 2024

Registered at 16650 W BLUEMOUND RD # 400B, BROOKFIELD, WI 530055920 (Tel: 4144765120)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 2500 N MAYFAIR RD, SUITE 340, WAUWATOSA, WI 532261409 (Tel: 4144765120)

📍

Updated Business Mailing Address July 08, 2007

Registered at 2500 N MAYFAIR RD, SUITE 340, WAUWATOSA, WI 532261409 (Tel: 4144765120)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN DECARLO, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Ophthalmology (License #21652-020 in WI)

🟢

Initial NPI Registration & Enumeration April 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1346204757

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 13, 2006

Last Update: February 19, 2024

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

16650 W Bluemound Rd # 400b

Brookfield, WI 530055920

Phone: 4144765120

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.