Rolf Smart Lulloff, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

16457 Issued in WI

Practice address

1715 Dousman St
Green Bay, WI 54303-3211

Phone

(920) 496-4700

Fax

(920) 496-4747

NPI assigned

Jul 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Prevea Clinic, Inc.

  • Internal Medicine Physician
  • Green Bay, WI
  • NPI 1306869276

  Orthopaedic Surgery

  NPD (past)
• Prevea Regional Services, Inc.

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1194748061
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1104859388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "address_2": "PREVEA HEALTH",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700",
            "fax_number": "920-496-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 DOUSMAN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033211",
            "telephone_number": "920-496-4700",
            "fax_number": "920-496-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LULLOFF",
        "first_name": "ROLF",
        "middle_name": "SMART",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "16457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30977000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mason James Lukas, PA-C
• Skyler Lukaszka, SACIT
• Ashley A Lukes, NP
• Andrew R Lulloff, D.D.S.
• Elizabeth A Lulloff, CRNA
• Sarah Jane Lulloff, MD
• Eric John Lund, PSY.D, BCBA-D, AND A
• Maria Jean Lundin, LPC-IT
• Mara Lungay, CRNA
• Jo Ellen Lusardi, RPH

• Orthopaedic Surgery Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Orthopaedic Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.