Dr. Heather Certain, MD - Internal Medicine in Madison, WI

Professional Overview & Biography Verified Profile Summary

Dr. Heather Certain, MD is a certified Internal Medicine practicing in Madison, WI. With approximately 23 years of clinical experience since graduating from University Of Wisconsin School Of Medicine in 2003, Dr. Certain delivers high-quality medical care to the local community at 202 SO PARK ST.

Dr. Certain is affiliated with Meriter Hospital Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, hospital discharge day management, more than, hospital discharge day management. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

202 So Park St
Meriter Hospital

Madison, WI 53715

Telephone 6084176103

Fax 6084175934

Medicare Profile & Education

Medical School

University Of Wisconsin School Of Medicine

Graduation Year

2003

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Madison, WI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

23 Yrs +3.2 yrs vs City Avg

City Avg: 19.8 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

426 Specialists

Practicing in Madison, WI (2181 Statewide)

Telehealth Adoption Rate

21.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

76.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Certain (23 Years) 23 Yrs

Madison Specialty Average (19.8 Years) 19.8 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
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	296	148	$281.00	$73.01
99239 Hospital discharge day management, more than 30 minutes	110	109	$447.00	$105.91
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	75	51	$423.00	$109.01
99238 Hospital discharge day management, 30 minutes or less	36	36	$327.00	$75.24
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	35	35	$725.00	$160.47
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	35	16	$281.00	$72.03
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	29	29	$497.00	$120.08
99231 Follow-up hospital inpatient care per day, typically 15 minutes	17	11	$209.00	$45.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	322	163	$276.00	$74.26
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	76	74	$487.00	$121.85
99239 Hospital discharge day management, more than 30 minutes	66	64	$439.00	$107.38
99238 Hospital discharge day management, 30 minutes or less	51	50	$320.00	$75.97
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	47	32	$415.00	$111.73
99231 Follow-up hospital inpatient care per day, typically 15 minutes	17	12	$205.00	$46.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	223	109	$271.02	$66.76
99239 Hospital discharge day management, more than 30 minutes	42	41	$431.01	$99.11
99238 Hospital discharge day management, 30 minutes or less	42	41	$313.00	$66.35
99217 Hospital observation care on day of discharge	34	32	$316.02	$67.40
99225 Subsequent observation care, typically 25 minutes per day	32	21	$306.00	$66.76
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	30	23	$407.00	$96.52
99219 Hospital observation care, typically 50 minutes	26	25	$539.98	$124.36
99231 Follow-up hospital inpatient care per day, typically 15 minutes	22	11	$201.00	$36.09
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	19	18	$476.02	$126.47
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	17	17	$696.96	$186.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	278	133	$266.00	$67.88
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	47	34	$399.00	$96.51
99239 Hospital discharge day management, more than 30 minutes	46	46	$423.00	$101.17
99217 Hospital observation care on day of discharge	43	43	$310.00	$68.60
99238 Hospital discharge day management, 30 minutes or less	41	41	$307.00	$68.60
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	29	29	$467.00	$128.74
99225 Subsequent observation care, typically 25 minutes per day	28	17	$300.00	$68.27
99219 Hospital observation care, typically 50 minutes	25	25	$529.00	$127.30
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	23	23	$683.00	$190.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	257	135	$261.00	$70.10
99239 Hospital discharge day management, more than 30 minutes	54	53	$415.00	$103.69
99217 Hospital observation care on day of discharge	43	42	$304.00	$70.21
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	37	36	$458.00	$132.47
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	36	31	$391.00	$100.96
99238 Hospital discharge day management, 30 minutes or less	32	31	$301.00	$70.61
99225 Subsequent observation care, typically 25 minutes per day	29	21	$294.00	$70.52
99219 Hospital observation care, typically 50 minutes	28	28	$519.00	$131.23
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	12	12	$670.00	$195.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	352	161	$255.00	$70.57
99239 Hospital discharge day management, more than 30 minutes	89	89	$405.00	$104.33
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	85	52	$383.00	$100.95
99238 Hospital discharge day management, 30 minutes or less	45	45	$293.00	$70.96
99217 Hospital observation care on day of discharge	36	36	$296.00	$70.97
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	36	36	$447.00	$132.39
99225 Subsequent observation care, typically 25 minutes per day	30	11	$288.00	$70.91
99219 Hospital observation care, typically 50 minutes	15	15	$509.00	$131.78
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	11	11	$655.00	$196.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	401	203	$250.00	$73.44
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	91	64	$375.00	$105.30
99239 Hospital discharge day management, more than 30 minutes	88	86	$397.00	$109.17
99238 Hospital discharge day management, 30 minutes or less	81	79	$287.00	$73.85
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	72	72	$438.00	$137.27
99217 Hospital observation care on day of discharge	38	38	$290.00	$73.68
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	14	14	$642.00	$204.25
99219 Hospital observation care, typically 50 minutes	14	14	$499.00	$137.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	238	147	$245.00	$69.21
99239 Hospital discharge day management, more than 30 minutes	90	88	$389.00	$103.47
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	89	66	$367.00	$100.23
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	53	52	$429.00	$131.03
99231 Follow-up hospital inpatient care per day, typically 15 minutes	49	33	$179.00	$37.60
99238 Hospital discharge day management, 30 minutes or less	40	40	$281.00	$69.79
99217 Hospital observation care on day of discharge	39	38	$284.00	$69.95
99219 Hospital observation care, typically 50 minutes	13	13	$489.00	$130.51
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	12	12	$629.00	$194.34

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License WI 49386-20

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.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License WI 49386

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.

Hospitalist

NUCC Taxonomy Code: 208M00000X

State License WI 49386-20

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Hospital & Practice Group Affiliations

Meriter Hospital Inc

202 S Park St, Madison, WI 537151507

Phone: 6084176000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Mary Vassalotti , APNP

Clinical Nurse Specialist - Acute Care

NPI 1184091050

Advanced Practice Nurse Prescriber

Dr. Dhanalakshmi Namasivayam , MD

Internal Medicine

NPI 1316142110

Doctor of Medicine (M.D.)

Dr. Catherine Ranheim , MD

Hospitalist

NPI 1356317424

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active July 02, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location July 02, 2012

Registered at 202 SO PARK ST, MERITER HOSPITAL, MADISON, WI 53715 (Tel: 6084176103)

📍

Updated Business Mailing Address July 02, 2012

Registered at 202 SO PARK ST, MERITER HOSPITAL, MADISON, WI 53715 (Tel: 6084176103)

👤

Provider Name / Credentials Updated July 02, 2012

Recorded as HEATHER CERTAIN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2012

Internal Medicine (License #49386-20 in WI)

🟢

Initial NPI Registration & Enumeration February 21, 2007

First registered as active Individual Practitioner in NPPES Database.

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Dr. Heather E Certain , MD