Active NPI 1417977430 Individual Practitioner Male Practitioner

Dr. Gary Edelman , MD

Surgery • Waupaca, WI

Professional Overview & Biography Verified Profile Summary

Dr. Gary Edelman, MD is a registered healthcare professional specializing in Surgery in Waupaca, WI. Practice services are available at 902 RIVERSIDE DR under active NPI credentials.

Frequently performed procedures and clinical services include new patient outpatient office visit, removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery, colorectal cancer screening; colonoscopy on individual at high risk. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

902 Riverside Dr

Waupaca, WI 549811992

Telephone 7152581160

Fax 7152563079

Associated Practice Facility / Clinic

🏢 Thedacare, Incorporated Facility NPI 1760528798

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Waupaca, WI

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

1 Specialists

Practicing in Waupaca, WI (765 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

86.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$490.71	$160.15
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	11	11	$2078.05	$182.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	25	25	$1696.92	$178.40
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	23	23	$1799.93	$117.41
99213 Established patient office or other outpatient visit, typically 15 minutes	22	22	$225.72	$69.60
99231 Follow-up hospital inpatient care per day, typically 15 minutes	21	12	$120.29	$37.89
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	19	19	$1987.70	$173.50
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$316.93	$103.27
99221 Initial hospital inpatient care per day, typically 30 minutes	15	15	$310.46	$97.69
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	14	14	$1700.67	$178.78
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$222.77	$72.55
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	12	12	$1365.64	$94.22
45378 Diagnostic exam of large bowel using a flexible endoscope	11	11	$1702.76	$179.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	43	43	$306.31	$102.96
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	32	32	$1969.94	$175.09
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	25	25	$1628.64	$174.21
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	24	24	$1634.51	$174.19
99202 New patient office or other outpatient visit, typically 20 minutes	22	22	$213.27	$72.88
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	20	20	$1346.91	$88.99
45378 Diagnostic exam of large bowel using a flexible endoscope	15	15	$1655.81	$178.63
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	14	$309.80	$104.08
43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	14	14	$1778.93	$141.17
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	12	12	$1726.72	$92.04
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$209.00	$71.00

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	35	35	$192.00	$5.17
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	21	21	$1893.00	$220.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$294.00	$98.24
99213 Established patient office or other outpatient visit, typically 15 minutes	19	19	$199.00	$69.93
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	17	17	$1566.00	$178.50
99202 New patient office or other outpatient visit, typically 20 minutes	16	16	$204.00	$71.78
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	15	15	$1566.00	$169.43
99201 New patient office or other outpatient visit, typically 10 minutes	13	13	$120.00	$42.50
45378 Diagnostic exam of large bowel using a flexible endoscope	11	11	$1587.00	$179.26
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$1292.00	$76.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	46	42	$193.00	$70.17
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	36	36	$113.00	$5.23
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	30	$286.00	$103.21
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	26	26	$1802.00	$196.98
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	23	23	$1580.00	$107.03
99231 Follow-up hospital inpatient care per day, typically 15 minutes	21	15	$104.00	$37.60
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	17	17	$1463.00	$179.39
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	15	15	$1463.00	$179.71
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$198.00	$68.44
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$1229.00	$81.91
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$285.00	$102.75
99201 New patient office or other outpatient visit, typically 10 minutes	11	11	$116.00	$41.85
45378 Diagnostic exam of large bowel using a flexible endoscope	11	11	$1511.00	$180.72

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License WI 30386

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

34265900 (WI)

Commercial Insurance / Payer ID Medicare Ptan

002469010 (WI)

Commercial Insurance / Payer ID Railroad Medicare

020052618 (WI)

Practice Associates & Co-Workers

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

25 Associated Practitioners

Dr. Ashley Tardieu , MD

Family Medicine

NPI 1073932331

Doctor of Medicine (M.D.)

Carmen Miller

Nurse Practitioner - Family

NPI 1104339001

Bradley Klein , APNP

Nurse Practitioner - Family

NPI 1114579612

Advanced Practice Nurse Prescriber

Dr. Sarah Durst , MD

Family Medicine

NPI 1114967312

Doctor of Medicine (M.D.)

Dr. Dorrie Happ , MD

Family Medicine

NPI 1144547027

Doctor of Medicine (M.D.)

Patty Kile

Family Medicine

NPI 1235291048

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active January 26, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location January 26, 2012

Registered at 902 RIVERSIDE DR, WAUPACA, WI 549811992 (Tel: 7152581160)

📍

Updated Business Mailing Address January 26, 2012

Registered at 710 RIVERSIDE DR, WAUPACA, WI 549811941 (Tel: 7152563000)

👤

Provider Name / Credentials Updated January 26, 2012

Recorded as GARY EDELMAN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 26, 2012

Surgery (License #30386 in WI)

🟢

Initial NPI Registration & Enumeration July 20, 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: 1417977430

Entity Type:

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

Enumeration Date: July 20, 2006

Last Update: January 26, 2012

Sole Proprietor: No

Update or Correct Profile

Mailing Address

710 Riverside Dr

Waupaca, WI 549811941

Phone: 7152563000

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.