NPIMap

Organization Active NPI

Door County Memorial Hospital

Doing business as Door County Medical Center

  • Critical Access Hospital
  • Sturgeon Bay, WI
National Provider Identifier
1093743874
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
DOOR COUNTY MEMORIAL HOSPITAL
Doing business as
Door County Medical Center
Practice address
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone
(920) 743-5566
NPI assigned
Jun 29, 2006
Last updated
Apr 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Authorized official

Name
Mr. Andrew S Laluzerne
Title
Cfo
Phone
(920) 746-3729

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X
Critical Access Hospital 282NC0060X WI Primary

Addresses

Primary practice location

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401

Mailing address

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 743-5566

Other identifiers 2

IdentifierTypeStateIssuer
11018400MedicaidWI
11018410MedicaidWI

Other names 1

  • Door County Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20040514000588 WI Part B Supplier - Clinic/Group Practice 5395735088 Receives reassigned benefits from 110 practitioners
Practice locations: Sister Bay, WI; Washington Island, WI; Sturgeon Bay, WI; Algoma, WI
O20061104000697 WI Part A Provider - Critical Access Hospital 5395735088 Receives reassigned benefits from 90 practitioners
1 other NPI on this enrollment
Practice locations: Sturgeon Bay, WI; Algoma, WI; Sister Bay, WI
O20081106000547 WI Part A Provider - Rural Health Clinic 5395735088 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sturgeon Bay, WI
O20081107000147 WI Part A Provider - Rural Health Clinic 5395735088 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sister Bay, WI
O20081107000157 WI Part A Provider - Rural Health Clinic 5395735088 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Algoma, WI

NPI to CCN mapping 4

The Medicare certification numbers (CCNs) connected to NPI 1093743874. Details of each certification follow.

Hospital certification: CCN 521358

Legal name
DOOR COUNTY MEMORIAL HOSPITAL
Doing business as
DOOR COUNTY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 13, 2006
Last certification
Jul 14, 2022
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Oct 16, 1944 in WI
Enrollment address
323S 18TH Ave
Sturgeon Bay, WI 54235-1401

Rural health clinic certification: CCN 528531

Legal name
DOOR COUNTY MEMORIAL HOSPITAL
Doing business as
DOOR COUNTY MEDICAL CENTER STURGEON BAY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 21, 2009
Last certification
Jun 6, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 16, 1944 in WI
Enrollment address
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Related CCNs
521358

Rural health clinic certification: CCN 528532

Legal name
DOOR COUNTY MEMORIAL HOSPITAL
Doing business as
DOOR COUNTY MEDICAL CENTER SISTER BAY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 12, 2009
Last certification
Jun 6, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 14, 1944 in WI
Enrollment address
2345 Canterbury LN
Sister Bay, WI 54234-5602
Related CCNs
521358

Rural health clinic certification: CCN 528530

Legal name
DOOR COUNTY MEMORIAL HOSPITAL
Doing business as
DOOR COUNTY MEDICAL CENTER ALGOMA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 26, 2009
Last certification
May 9, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 16, 1944 in WI
Enrollment address
815 Jefferson St
Algoma, WI 54201-1733
Related CCNs
521358

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Door County Medical CenterCCN 521358 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1300 Egg Harbor Rd
Sturgeon Bay, WI 54235
Phone (920) 746-0410

1843 Michigan St
Sturgeon Bay, WI 54235
Phone (920) 746-0090

910 Main Rd
Washington Island, WI 54246
Phone (920) 743-5566

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Edgar K Collison Individual Corporate DirectorBoard Member May 14, 2025
Patricia M Vickman Individual Corporate DirectorBoard Member Oct 1, 2017
Pauline M Helm Individual Corporate DirectorBoard Member Jan 1, 2023
Andrew S Laluzerne Individual Corporate OfficerCfo Oct 29, 2018
Joseph Joshua Rebhan Individual Corporate DirectorBoard Member Jan 1, 2026
Martha S Ziegelbauer Individual Corporate DirectorBoard Member Jan 1, 2022
Michael R St Jean Individual Corporate DirectorBoard Member Jan 1, 2025
Jamie D Alberts Individual Corporate DirectorBoard Member Jan 1, 2021
Tammy a Sternard Individual Corporate DirectorBoard Member Jan 1, 2025
Joel C Kitchens Individual Corporate DirectorBoard Member Jan 1, 2021
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Organization, Green Bay, WI Corporation, Non-profit Operational/Managerial Control Nov 1, 2016 40%
Erin Rae Helgeson Individual Corporate DirectorBoard Member Jan 1, 2024
Dorene E Dempster Individual Corporate DirectorBoard Member/ Medical Staff Preside Jan 1, 2019
Corporate DirectorBoard Member/Medical Staff Presiden Jan 1, 2019
Corporate DirectorBoard Member Jan 1, 2019
Bradley S Andreae Individual Corporate DirectorBoard Member Jan 1, 2024
Jeffrey J Rabas Individual Corporate DirectorBoard Member Jan 1, 2022
Jonathan L Jarosh Individual Corporate DirectorBoard Member Jan 1, 2024
Robert Erickson Individual Corporate DirectorBoard Member May 15, 2024
Brian C Stephens Individual Corporate OfficerCeo Jan 6, 2019
Operational/Managerial ControlCeo Jan 6, 2019
Corwin D Dahl Individual Corporate DirectorBoard Member Jan 1, 2021
Corporate DirectorBoard Member Feb 1, 2021
Andrew Richmond Individual Corporate DirectorBoard Member Oct 1, 2017

Owners & managing parties with NPI records 19

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 19

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 158

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 158

Affiliated clinicians 311

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 311

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1093743874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-743-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-743-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOOR COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "LALUZERNE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-746-3729",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11018400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11018410",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Door County Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sturgeon Bay, WI

Sources for this page

Verify at the official NPI Registry.