MICHAEL P FETHERSTON (MD) – Family Medicine Physician, NPI 1639130040
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,050 FAMILY PRACTICE in WI
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Provider Addresses for MICHAEL P FETHERSTON (MD)
Columbia College of Nursing, 4425, North Port Washington Road, Grover Heights, Glendale, Milwaukee County, Wisconsin, 53212, United States
ATTN: CSMCP CLINIC CREDENTIALING
GLENDALE, WI 532121082
Phone: (414) 270-8150
Type: Mailing
9233, North Green Bay Road, Brown Deer, Milwaukee County, Wisconsin, 53223, United States
BROWN DEER, WI 532091103
Phone: (414) 270-8150
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $23.
Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.
Last reported payment date: 2024-07-24 • Largest payer in this snapshot: Dynavax Technologies Corporation ($23).
Total Amount
$23
General + Research + Ownership
Payments
1
Total payment records
General Amount
$23
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dynavax Technologies Corporation | $23 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-01-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080128000090 | I | Family Practice | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 237 | 145 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 128 | 128 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 28 | 19 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 20 | 19 | $0 |
Insurance plans in this area (ZIP 53212)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Diagnostic Radiology | WI | |
| D E R M A T O L O G Y | WI | |
| - | WI | |
| - | WI | |
| - | WI | |
| H E M A T O L O G Y/ O N C O L O G Y | WI | |
| - | WI | |
| - | WI | |
| - | WI |
Reviews
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