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PROVIDER PROFILE · NPI 1104961465

Heather CertainMD

Internal MedicineMadison, WII
CROSS-REFERENCE

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ProviderScore
OIG/SAM exclusion screening, sanctions history
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QUALITY · MIPS · 2024
Final MIPS score
87.6
Quality
84.6
Cost
81.6
Improvement activities
40.0
Promoting interop.
91.0
Payment adjustment
0.53%
Group
FACILITY AFFILIATIONS

Hospital & Facility Affiliations (2)

CCN 520089
Hospital
CCN 520098
Hospital
PRESCRIBING · PART D · 2024
Total Rx claims
138
Beneficiaries
—
Total drug cost
$11K
Distinct drugs
8
Brand share
11.6%
Top prescribed drugs
Pantoprazole Sodium26 claims
Metoprolol Succinate22 claims
Furosemide21 claims
Apixaban16 claims
Atorvastatin Calcium15 claims
MEDICARE UTILIZATION · PART B · 2024
Total beneficiaries
435
Unique beneficiaries
—
Total services
633
Distinct HCPCS
7
Medicare payment
$43K
Peer benchmark
Q1
Q2
Q3
Q4
Q5
Total Medicare services vs. 1,244 Internal Medicine providers in WI — above median (cohort median 578).
INDUSTRY PAYMENTS · OPEN PAYMENTS · 2024
No data available for this provider in 2024.
REFERRAL NETWORK

Where Heather Certain's patients come from & go

Directional shared-patient flow from Medicare claims — who sends patients to this provider (inbound) and where this provider's patients go next (outbound). 39 inbound referrers · 59 outbound destinations.

Receives referrals from
Inbound — who sends patients here
PhysicianPatientsVisits
MERITER HOSPITAL, INC.191453
Mona Lazar
Internal Medicine · Madison, WI
4974
Shoba Narayan
Internal Medicine · Madison, WI
3350
Jason Yelk
Internal Medicine · Madison, WI
3261
Lynn Broderick
Diagnostic Radiology · Madison, WI
3265
Meriter Health Enterprises Inc.
Clinical Laboratory · Madison, WI
2993
Peter Chase
Diagnostic Radiology · Madison, WI
2742
Simone Glinberg
Endocrinology · Madison, WI
2438
Thomas Wallhaus
Cardiology · Madison, WI
2236
Robert Bour
Diagnostic Radiology · Madison, WI
2231
Paul Hinderaker
Cardiology · Madison, WI
2239
Sarah Silver
Emergency Medicine · Hartford, WI
2227
Refers patients to
Outbound — where patients go next
PhysicianPatientsVisits
MERITER HOSPITAL, INC.197484
Mona Lazar
Internal Medicine · Madison, WI
5386
Meriter Health Enterprises Inc.
Clinical Laboratory · Madison, WI
42110
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY41121
City Of Madison
Ambulance Service Provider · Madison, WI
4049
Edward Borman
Diagnostic Radiology · Madison, WI
4071
Mohammed Saghir
Cardiology · Kansas City, MO
3654
Shoba Narayan
Internal Medicine · Madison, WI
3453
Francis Thornton
Diagnostic Radiology · Iowa City, IA
3259
MERITER HEALTH ENTERPRISES, INC.3051
John Michael Khalil
Diagnostic Radiology · Madison, WI
3042
Peter Chase
Diagnostic Radiology · Madison, WI
2938
Source: CMS Physician Shared Patient Patterns (30-day window, Medicare FFS). Direction = a beneficiary seen by the first provider, then the second, within 30 days; a proxy for referral, not a documented referral. Pairs with fewer than 11 shared beneficiaries are suppressed.