Active NPI 1134142615 Individual Practitioner Male Practitioner

Dr. Michael J Heili , MD

Surgery • Sheboygan, WI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Heili, MD is a certified Surgery practicing in Sheboygan, WI. With approximately 39 years of clinical experience since graduating from University Of Wisconsin School Of Medicine in 1987, Dr. Heili delivers high-quality medical care to the local community at 2920 SUPERIOR AVE.

Dr. Heili is affiliated with St. Nicholas Hospital-Sisters Of The Third Order Of St Francis and accepts Medicare assignment.

Frequently performed procedures and clinical services include removal of polyps or growths of large bowel using an endoscope with mechanical snare, colorectal cancer screening; colonoscopy on individual at high risk, initial hospital care with moderate level of medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2920 Superior Ave

Sheboygan, WI 530811944

Telephone 9204964700

Fax 9204583163

Associated Practice Facility / Clinic

🏢 Sheboygan Internal Medicine Associates, Sc Facility NPI 1922161728

Medicare Profile & Education

Medical School

University Of Wisconsin School Of Medicine

Graduation Year

1987

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Sheboygan, WI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

39 Yrs +20.8 yrs vs City Avg

City Avg: 18.2 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

10 Specialists

Practicing in Sheboygan, WI (765 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

88.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Heili (39 Years) 39 Yrs

Sheboygan Specialty Average (18.2 Years) 18.2 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
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	28	28	$2540.25	$234.03
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	13	13	$1865.75	$168.82
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	11	11	$496.50	$168.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	46	46	$2540.25	$236.32
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$487.17	$165.84
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	14	14	$1865.75	$171.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito	38	38	$165.00	$4.98
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	29	28	$486.50	$188.79
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	28	28	$2540.25	$239.90
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	24	14	$211.00	$68.08
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$1716.00	$101.17
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	11	11	$2318.02	$408.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito	55	55	$165.00	$5.04
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	32	32	$2540.25	$242.32
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	21	21	$75.00	$35.33
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	20	20	$486.50	$191.45
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	14	11	$211.00	$61.23
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	13	13	$1865.75	$176.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$242.00	$116.81
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	12	12	$1716.00	$104.49
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$247.25	$107.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito	62	61	$165.00	$5.26
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	34	34	$2540.25	$234.64
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	24	$486.50	$197.78
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	23	16	$211.00	$70.87
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$247.25	$104.49
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$242.00	$105.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito	79	79	$165.00	$5.21
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	42	42	$2540.25	$245.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	27	$242.00	$105.45
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	26	17	$211.00	$69.04
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	24	$486.50	$196.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$247.25	$104.11
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	14	14	$1716.00	$99.24
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	13	13	$1865.75	$180.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito	61	61	$165.00	$5.00
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	32	19	$211.00	$66.03
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	26	26	$2540.25	$233.25
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	23	$486.50	$181.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	19	$242.00	$100.16
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	15	15	$1716.00	$105.57
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$247.25	$99.33
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	14	14	$1865.75	$173.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito	34	34	$165.00	$5.23
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	30	30	$2540.25	$248.88
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	22	$241.00	$98.09
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	19	18	$486.50	$194.34
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	18	12	$211.00	$69.44
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	17	17	$165.00	$11.88

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License WI 30902

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Specialist

NUCC Taxonomy Code: 174400000X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

34925300 (WI)

Hospital & Practice Group Affiliations

St. Nicholas Hospital-Sisters Of The Third Order Of St Francis

2920 Superior Ave, Sheboygan, WI 530811944

Phone: 9204583791

Practice Associates & Co-Workers

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

40 Associated Practitioners

Dr. Mark Kachan , DPM

Podiatrist

NPI 1003080102

Doctor of Podiatric Medicine

Dr. Susan Evans , DPM

Podiatrist

NPI 1003131061

Doctor of Podiatric Medicine

Cassandra Vanstraten , LPC

Counselor - Mental Health

NPI 1003478793

Licensed Professional Counselor

Rachel Rejniak , AGPCNP-BC

Nurse Practitioner - Gerontology

NPI 1003537150

AGPCNPBC

Junhong Pace , NP

Nurse Practitioner - Family

NPI 1003597063

Nurse Practitioner

Dr. Mary Bartel , MD

Pediatrics

NPI 1003831314

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 March 23, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location March 23, 2015

Registered at 2920 SUPERIOR AVE, SHEBOYGAN, WI 530811944 (Tel: 9204964700)

📍

Updated Business Mailing Address March 23, 2015

Registered at 2920 SUPERIOR AVE, SHEBOYGAN, WI 530811944 (Tel: 9204964700)

👤

Provider Name / Credentials Updated March 23, 2015

Recorded as MICHAEL HEILI, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 23, 2015

Specialist

🟢

Initial NPI Registration & Enumeration July 25, 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: 1134142615

Entity Type:

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

Enumeration Date: July 25, 2006

Last Update: March 23, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2920 Superior Ave

Sheboygan, WI 530811944

Phone: 9204964700

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.