Active NPI
Horace Pei Lo, M.D.
- Surgery Physician
- Berlin, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 39102-020
- Practice address
- 225 Memorial Dr Ste 2000
Berlin, WI 54923-1243 - Phone
- (920) 361-5340
- NPI assigned
- Mar 28, 2006
- Last updated
- Jun 9, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 39102-020 | WI | Primary |
Addresses
Primary practice location
225 Memorial Dr Ste 2000
Berlin, WI 54923-1243
Mailing address
225 Memorial Dr Ste 2000
Berlin, WI 54923-1243
Phone (920) 361-5340
Other practice location 1
9515 Holy Cross Ln
Breese, IL 62230-3618
Phone (618) 526-8430
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114988466 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hlo394937@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
608 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6800
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 37 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 47 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 11 |
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39102-020 | WI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Ridge Health, Inc. | Current | Accepting new patients | |
| Watertown Physician Practices LLC | Current | Accepting new patients | |
| Agnesian Healthcare, Inc | Current | Accepting new patients | |
| Agnesian Healthcare Inc | Current | Accepting new patients | |
| Prairie Ridge Health Inc. | Current | Accepting new patients | |
| Watertown Physician Practices LLC | Current | Accepting new patients |
Locations
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
225 Memorial Dr
Ste 2000
Berlin, WI 54923
Phone (920) 361-5340
1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200
420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400
430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200
360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111
845 Parkside St
Ripon, WI 54971
Phone (920) 748-3101
933 Newbury St
Ripon, WI 54971
Phone (920) 748-0430
123 Hospital Dr
Ste 2000
Watertown, WI 53098
Phone (920) 206-3042
1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111
608 W Brown St
Waupun, WI 53963
Phone (920) 324-6800
Interoperability endpoints
- hlo119919@direct.thedacare.org
- hlo332769@direct-ehr-ssmhc.com
- hlo394937@ewd.direct.hshs.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba SSM Health St Agnes Hospital Fond Du Lac
- General Acute Care Hospital
- Fond Du Lac, WI
- NPI 1346228541
-
- Critical Access Hospital
- Columbus, WI
- NPI 1154403657
-
- Family Medicine Physician
- Watertown, WI
- NPI 1770964363
-
dba Prairie Ridge Health Clinic-Sun Prairie
- Family Medicine Physician
- Sun Prairie, WI
- NPI 1699534545
-
- Obstetrics & Gynecology Physician
- Watertown, WI
- NPI 1225412265
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba SSM Health St Agnes Hospital Fond Du Lac
- General Acute Care Hospital
- Fond Du Lac, WI
- NPI 1346228541
-
dba SSM Health Ripon Community Hospital
- Critical Access Hospital
- Ripon, WI
- NPI 1053362624
-
dba SSM Health Waupun Memorial Hospital
- Medicare Defined Swing Bed Hospital Unit
- Waupun, WI
- NPI 1528046737
-
dba SSM Health Waupun Memorial Hospital
- Critical Access Hospital
- Waupun, WI
- NPI 1548248644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686268800000",
"number": "1114988466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 MEMORIAL DR STE 2000",
"city": "BERLIN",
"state": "WI",
"postal_code": "549231243",
"telephone_number": "920-361-5340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MEMORIAL DR STE 2000",
"city": "BERLIN",
"state": "WI",
"postal_code": "549231243",
"telephone_number": "920-361-5340"
}
],
"practiceLocations": [
{
"address_1": "9515 Holy Cross Ln",
"address_purpose": "LOCATION",
"city": "Breese",
"state": "IL",
"postal_code": "622303618",
"country_code": "US",
"telephone_number": "618-526-8430",
"fax_number": "618-526-7275",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LO",
"first_name": "HORACE",
"middle_name": "PEI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2023-06-09",
"certification_date": "2023-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "39102-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1114988466",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hlo394937@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "9515 Holy Cross Ln",
"city": "Breese",
"state": "IL",
"country_code": "US",
"postal_code": "622303618",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.