Justin Cummins, MD
NPI 1003911603 · Orthopaedic Surgery Physician · Ashland, WI
Enrolled with Medicare as Practitioner - Orthopedic Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Justin Cummins, MD is a Orthopaedic Surgery Physician provider in Ashland, WI (NPI 1003911603).
Provider details
- NPI number
- 1003911603
- Entity type
- Individual
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 51884 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
19 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
60 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| X-Ray of Knee, 4 Or More Views73564 | 20 | $34 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 14 | $158 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 14 | $122 |
| Insertion of Needle Into Vein for Collection of Blood Sample36415 | 12 | $9 |
Typical Medicare-allowed amounts for these services range $9–$158 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 6 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Dexamethasone | 47 | 43 |
| Oxycodone Hcl | 42 | 32 |
| Oxycodone Hcl/Acetaminophenbrand: Oxycodone-Acetaminophen | 22 | 21 |
| Tramadol Hcl | 13 | — |
| Gabapentin | 11 | — |
| Hydrocodone/Acetaminophenbrand: Hydrocodone-Acetaminophen | 11 | — |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they include cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means , never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$95 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-09-14
- Last updated
- 2018-08-29
Frequently asked questions
- What is Justin Cummins's NPI number?
- Justin Cummins's National Provider Identifier (NPI) is 1003911603, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Justin Cummins's specialty?
- Justin Cummins is listed in the NPPES registry with a primary specialty of Orthopaedic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Justin Cummins located?
- Justin Cummins's practice location on file with NPPES is 1615 Maple Lane, Ashland, WI 54806.
- What is Justin Cummins's phone number?
- The practice phone number listed in the NPPES registry for Justin Cummins is (715) 685-5500.
- Does Justin Cummins accept Medicare?
- Justin Cummins is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Justin Cummins's NPI active?
- Yes — Justin Cummins's NPI (1003911603) is active in the NPPES registry as of the last update on 2018-08-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.