Justin Shawn Cummins, MD
Orthopaedic Surgery Physician · Ashland, WI
Justin Shawn Cummins, MD is an orthopaedic surgery physician with a practice address in Ashland, Wisconsin, and NPI 1003911603, issued on Sep 14, 2006. Check the license (Wisconsin 53249-20, as entered in NPPES) on the Wisconsin Medical Examining Board; the Medicare figures below come from public CMS files.
- Name
- Justin Shawn Cummins
- Credential
- MD
- Primary taxonomy
- Orthopaedic Surgery Physician 207X00000X
- License numbers
- 53249-20 WI
51884 MN
Self-reported in NPPES; status is on the state search - Practice location
- 1615 Maple Lane, Ashland, WI 54806
- Phone
- (715) 685-5500
- Enumerated
- Sep 14, 2006
- Record last updated
- Aug 29, 2018 (not updated in 8 years: call before relying on the address or phone)
- Medicare enrollment
- Enrolled (PECOS I20091001000154); accepts Medicare assignment
- Medical or professional school
- University Of Washington School Of Medicine, 2002
- Entity
- Type 1 · individual
8 nearest orthopaedic surgery physician records → All 656 in Wisconsin → Look up another NPI →
Also registered at 1615 Maple Lane
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Enrique Africano, MDObstetrics & Gynecology Physician1184617862
- Amy Berger, PA-CPhysician Assistant1093991739
- Matthew Bettendorf, M.D.Surgery Physician1932254729
- Shawn Brede, CRNACertified Registered Nurse Anesthetist1811965965
- Stephen Cushing, CRNACertified Registered Nurse Anesthetist1598729378
- Leah Danner, M.D.Ophthalmology Physician1689627119
Verify Justin Shawn Cummins in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWisconsin Medical Examining Board
Search for license 53249-20Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
44% fewer Medicare Part D claims than the average orthopaedic surgery physician in 2024
193 Medicare Part D claims for 122 beneficiaries, against an average of 346 among the 16,516 providers of this specialty who prescribed in Part D. 95 claims were for opioids.
Most prescribed
- Dexamethasone47 claims
- Oxycodone Hcl42 claims
- Oxycodone-Acetaminophen22 claims
- Tramadol Hcl13 claims
- Gabapentin11 claims
- Hydrocodone-Acetaminophen11 claims
Source: CMS Medicare Part D Prescribers by Provider and Drug, 2024 (data.cms.gov). Part D covers prescriptions for Medicare patients only; drugs with fewer than 11 claims are not published.
The practice group's MIPS final score for 2023 (Medicare payment program): 89.7 of 100
The Merit-based Incentive Payment System score is reported for the practice group, not for one clinician alone. Four categories are weighted into the final score; the average among 454,083 clinicians with a measured score was 83.5.
Source: CMS Quality Payment Program, MIPS performance year 2023, group reporting; category weights for 2023 (qpp.cms.gov).
Industry payments in 2024: $94.54
1 payment: food and beverage; the largest payer was DePuy Synthes Sales Inc. The 15,003 providers of this specialty with any payment received $23,022.89 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
Bills Medicare through 3 group practices
- Advantage Physical Therapy And Sports Rehab, LLCHayward, WI
- Memorial Medical Center IncAshland, WI
- Polinsky Medical Rehabilitation CenterDuluth, MN
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Justin Shawn Cummins among 656 orthopaedic surgery physician records in Wisconsin
Justin Shawn Cummins, MD is one of 656 orthopaedic surgery physician records with a practice address in Wisconsin. 71% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2006, is newer than 15% of them.
- NPI issued2006 · 15% of these records are older, 41% newer
- In a Medicare fileYes · 71% of these records are
- In the CMS Doctors and Clinicians fileYes · 61% of these records are
- Graduated2002 · median 2006 among the 401 with a school on file
- Record last updated2018 · 50% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 207X00000X and a Wisconsin practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
4 orthopaedic surgery physician records list a practice address in Ashland
They are 4 of the 366 NPPES records with a practice address in Ashland, and 656 orthopaedic surgery physician records in Wisconsin.
All 656 in Wisconsin → Every provider in Ashland → Orthopaedic Surgery Physician nationwide →
The 8 orthopaedic surgery physician records with the nearest ZIP codes
- Dean Rau, MDAshland, WI 548061568438331
- Joseph Signorelli, MDAshland, WI 548061528165081
- Scott Warren, MDAshland, WI 548061992795967
- Joshua BaltsBarron, WI 548121104184092
- James Leavitt, MDBarron, WI 548121710967351
- James Haemmerle, M.D.Menomonie, WI 547511932151545
- Paul McNally, D.O.Menomonie, WI 547511093758450
- Van Wahlgren, MDMenomonie, WI 547511720077605
Common questions
What is Justin Shawn Cummins, MD's NPI number?
Justin Shawn Cummins, MD's National Provider Identifier (NPI) is 1003911603, issued on Sep 14, 2006. An NPI identifies a provider in billing; it is not a license.
Where is Justin Shawn Cummins, MD located?
The NPPES record lists a practice address at 1615 Maple Lane, Ashland, WI, 54806. Phone: (715) 685-5500. Providers update this record themselves, so call before visiting.
How can I verify Justin Shawn Cummins, MD's license?
NPPES lists Wisconsin license number 53249-20, as entered by the provider. Search the Wisconsin Medical Examining Board at https://dsps.wi.gov/Pages/BoardsCouncils/MEB/Default.aspx. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
How much does Justin Shawn Cummins, MD prescribe under Medicare Part D?
In 2024, Justin Shawn Cummins, MD had 193 Medicare Part D claims for 122 beneficiaries; the average among orthopaedic surgery physician prescribers was 346. Part D covers Medicare prescriptions only.
What is Justin Shawn Cummins, MD's MIPS final score?
The 2023 MIPS final score is 89.7 of 100, reported for the practice group. The average among 454,083 clinicians with a measured score was 83.5.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.