NPIMap

Individual provider Active NPI

Mary Fitzgerald Lovelien, PA-C

  • Medical Physician Assistant
  • Sheboygan, WI
National Provider Identifier
1063567105
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2078-023 Issued in WI
Practice address
1703 N Taylor Dr
Sheboygan, WI 53081-1933
Phone
(920) 457-4438
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2078-023 WI Primary

Addresses

Primary practice location

1703 N Taylor Dr
Sheboygan, WI 53081-1933

Mailing address

1703 N Taylor Dr
Sheboygan, WI 53081-1933
Phone (920) 457-4438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070213000032 WI Practitioner - Physician Assistant 6901808450 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Clare Memorial Hospital, IncGroup PAC ID 0446211395, 62 clinicians

Practice addresses (Care Compare)

1300 E Green Bay St
Shawano, WI 54166-2210
Phone (920) 496-4700

1821 S Webster Ave
Green Bay, WI 54301-2253
Phone (920) 496-4700

2793 Lineville Rd
Green Bay, WI 54313-7152
Phone (920) 496-4700

835 S Main St
Oconto Falls, WI 54154-1282

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2078-023WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prevea Clinic, Inc. CurrentSince Aug 6, 2018 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 6, 2018 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 6, 2018 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Aug 6, 2018 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Aug 19, 2018 Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince Aug 19, 2018 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

1703 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 457-4438

1414 N Taylor Dr
Ste 210
Sheboygan, WI 53081
Phone (262) 243-2500

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1063567105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811933",
            "telephone_number": "920-457-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811933",
            "telephone_number": "920-457-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELIEN",
        "first_name": "MARY",
        "middle_name": "FITZGERALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "2078-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.