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2021 Healthpartners Robin Plan Provider Directory

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® HealthPartners Robin Birch (PPO) ® HealthPartners Robin Maple (PPO) 2021 HealthPartners Robin Plan Provider Directory H4882_000686_C IR 09/2020 This directory is current as of Sept. 9, 2021. This directory is current as of August 24, 2020. This directory provides a list of HealthPartners® Robin current network providers. For pharmacy information refer to your Pharmacy directory. This directory provides a list of HealthPartners Robin current network providers. For pharmacy information refer to your Pharmacy directory. This directory is for the northeastern Wisconsin counties included in our service area, which are: Brown, Calumet, Florence, Green Lake, Kewaunee, Manitowoc, Marinette, Marquette, This directory is for the northeastern Wisconsin Medicare Advantage counties included in our Menominee, Oconto, Outagamie, Shawano, Waupaca, Waushara and Winnebago. service area, which are: Brown, Calumet, Florence, Green Lake, Kewaunee, Manitowoc, Marinette, Marquette, Menominee, Oconto, Outagamie, Shawano, Waupaca, Waushara and To access HealthPartners online provider directory, you can visit Winnebago. healthpartners.com/medicarenetworks. To access HealthPartners online provider directory, you can visit For any questions about the information contained in this directory, please call our Member healthpartners.com/medicarenetworks. For any questions about the information contained in Services department at 866-233-8734, TTY users should call 711. this directory, please call our Member Services department at 866-233-8734, TTY users should call 711. From Oct. 1 through March 31, we take calls from 8 a.m. to 8 p.m. CT, seven days a week. You’ll speak with a representative. From Oct. 1 through March 31, we take calls from 8 a.m. to 8 p.m. CT, seven days a week. You’ll speak with a representative. From April 1 through Sept. 30, call us 8 a.m. to 8 p.m. CT Monday through Friday to speak From April 1 through Sept. 30, call us 8 a.m. to 8 p.m. CT Monday through Friday to speak with a with a representative. On Saturdays, Sundays and Federal holidays, you can leave a representative. On Saturdays, Sundays and Federal holidays, you can leave a message and we’ll message and we’ll get back to you within one business day. get back to you within one business day. This document is available in alternate formats. Please call Member Services for more This document is available in alternate formats. Please call Member Services for more information. information. Table of contents Section I – Introduction What is the service area for HealthPartners® Robin? ........ 3 How do you find HealthPartners® Robin providers that serve your area? ............................................ 3 Section 2 - List of network providers Primary care providers (PCPs) and specialists ................... 4 Hospitals and outpatient surgical centers .......................... 88 Outpatient Mental health/substance abuse providers .......90 Skilled nursing facilities (SNFs) .......................................95 Online Clinic ......................................................................97 Hearing Aids (TruHearing®) ............................................. 98 Dental care ..........................................................................99 After-hours/urgent care ....................................................100 Walk-in clinics (convenience care) .................................102 Additional providers can be found at healthpartners.com/medicarenetworks 1 Section I – Introduction This directory provides a list of HealthPartners In most cases, if you get care from an out-of-network Robin’s network providers. To get detailed provider, that provider must participate in Medicare. information about your health care coverage, please Except for emergency care, we cannot pay a provider see your Evidence of Coverage (EOC). who does not participate in Medicare. If you receive care from a provider who does not participate in The network providers listed in this directory have Medicare, you will be responsible for the full cost of agreed to provide you with your health care, vision the services you receive. Check with your provider and dental services. You may go to any of our before receiving services to confirm that they network providers listed in this directory. Other participate in Medicare. providers are available in the network. If you have been going to one network provider, you are not You don’t need to get a referral or prior authorization required to continue to go to that same provider. when you get care from out-of-network providers. However, before getting services from out-of-network Out-of-network providers are under no obligation providers you may want to ask for a pre-service to treat HealthPartners Robin enrollees, except in organization determination to confirm that the emergencies. For a decision about whether we will services you are getting are covered and are medically cover an out-of-network service, we encourage you or necessary. your provider to ask us for a pre-service organization determination before you receive the service. If an out-of-network provider asks you to pay for Please call our Member Services department at covered services, please contact Member Services 866-233-8734, TTY:711. From Oct. 1 through prior to paying your bill. To submit claims, you March 31, we take calls from 8 a.m. to 8 p.m. CT, should mail them to: seven days a week. From April 1 through Sept. 30, call us 8 a.m. to 8 p.m. CT, Monday through Friday HealthPartners Claims Dept. to speak with a representative. On Saturdays, Sundays 8170 33rd Ave. S. and Federal holidays, you can leave a message and P.O. Box 1289 we’ll get back to you within one business day. You Minneapolis, MN 55440-1289 may also refer to your Evidence of Coverage (EOC) When you are outside the service area and cannot for more information, including the cost sharing that get care from a network provider, you may receive applies to out-of-network services. emergency and urgently needed care from the closest You can choose to receive care from out-of-network available provider. providers. Our plan will cover services from either In addition, when out of the service area you can in-network or out-of-network providers, as long as obtain dialysis treatment from any qualified dialysis the services are covered benefits and are medically provider. With the exception of emergencies or urgent necessary. However, if you use out-of-network care, it may cost more to get care from out-of-network providers, your share of the costs for your covered providers. services may be higher. 2 What is the service area for HealthPartners® Robin? The counties in our service area are listed below. Brown, Calumet, Florence, Green Lake, Kewaunee, Manitowoc, Marinette, Marquette, Menominee, Oconto, Outagamie, Shawano, Waupaca, Waushara, Winnebago. How do you find HealthPartners® Robin providers that serve your area? The Table of Contents lists the sections of this directory. To find a provider, look in the applicable provider specialty section and then find your state, county or city closest to you. If you have questions about HealthPartners Robin, please call our Member Services department at 866-233-8734, TTY: 711. From Oct. 1 through March 31, we take calls from 8 a.m. to 8 p.m. CT, seven days a week. From April 1 through Sept. 30, call us 8 a.m. to 8 p.m. CT, Monday through Friday to speak with a representative. On Saturdays, Sundays and Federal holidays, you can leave a message and we’ll get back to you within one business day. You can also visit healthpartners.com/medicarenetworks. 3 Section 2 - List of network providers Primary care providers (PCPs) and specialists Providers are organized first by state, city, then alphabetically by type and facility name. HealthPartners Robin contracts with more than 2,411 primary care and 13,726 specialty providers. Timothy E. Tanke, MD WISCONSIN PODIATRY AUDIOLOGY Richard J. Timmons, MD Rahul Verma, MD Peninsula Podiatry LLC at DCMC Ear Nose & Throat Surgical Algoma, WI Abigail M. Witthuhn, PA-C Algoma Clinic Associates Christopher M. Wolfram, 815 Jefferson St 1520 N Meade St MD CARDIOLOGY Algoma, WI 54201 Appleton, WI 54911 Dong Bo Yu, MD Bellin Health (920) 743-6668 (920) 734-7181 831 Parker Ave Kristin K. Borgen, AuD DERMATOLOGY REHABILITATION THERAPY Beth J. Gabavics, AuD Algoma, WI 54201 Jacqueline N. Maxam, Forefront Dermatology (920) 487-3676 Bellin Health AuD 3935 N Lightning Dr Paul A. Hudson, MD 831 Parker Ave Appleton, WI 54913 Algoma, WI 54201 CARDIOLOGY (920) 968-1790 FAMILY MEDICINE Hillary M. Ahola, PA-C (920) 487-3676 Aurora Cardiovascular Services Bellin Health Physical Therapy David E. Bertler, MD 1611 S Madison St Lisa L. Campbell, MD 831 Parker Ave Marcus A. Boehm, PT Appleton, WI 54915 Nicole L. Cote, MD Algoma, WI 54201 (920) 730-6700 Cory J. Duprey, MD (920) 487-3676 UROLOGY Peter J. Katz, MD Robert J. Anderson, MD ThedaCare Cardiovascular Care - Michelle D. Lewis, MD Katie A. Lukes, NP-F Urology Associates of Green Bay Appleton Sheetal Mehta, MD Sarah C. Sanchez, MD 1510 Fremont St 1818 N Meade St Marcella K. Teske, NP-F Algoma, WI 54201 Appleton, WI 54911 Brent R. Weed, MD NUTRITION (920) 433-9400 (920) 731-8900 Kagen Dermatology Clinic, SC Bellin Health Donnevan Blake, MD 100 W Lawrence St Ste 409 Appleton, WI Lisa M. Grothe, NP-F 831 Parker Ave Purnima Hirudayaraj, MD Appleton, WI 54911 Algoma, WI 54201 Paul A. Hudson, MD (920) 733-5138 (920) 487-3676 ALLERGY Patrick J. Hughes, MD Charles N. Kagen, MD Roxanne M. Schauer- Mohammad R. Jazayeri, Denneau, CD Allergy And Asthma Associates NEW Dermatology Group Ltd SC MD Samantha S. Kapphahn, 2500 E Capitol Dr ORTHOPEDICS 436 E Longview Dr Ste B DO Appleton, WI 54911 Appleton, WI 54911 Anna L. King, PA-C (920) 365-0345 Bellin Health (920) 739-5213 Lauren R. Kraft, NP Joshua R. Hickman, PA-C 831 Parker Ave Karen R. Konz, DO Rony Lahoud, MD Matthew A. Rand, PA-C Algoma, WI 54201 Allergy & Immunology Verghese Mathew, MD (920) 487-3676 Gabriel B.
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