Mary Mackenzie Lane-Peot, DNP
Individual provider Active NPI Family Nurse Practitioner · Tomah, WI
NPI 1144110768 · NPPES record last updated Jul 7, 2025
Key facts
- NPI
- 1144110768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 17025-33 (WI)
- Practice address
- 501 Gopher Dr
Tomah, WI 54660-4513 - Phone
- (608) 372-2181
- NPI assigned
- Jul 7, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tomah Memorial Hospital Inc
Practice addresses (Care Compare)
501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181
Hospital & facility affiliations
- Tomah Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250811001609 | WI | Practitioner - Nurse Practitioner | 5294233128 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tomah Memorial Hospital Inc | Current |
Accepting new patients | |
| Tomah Memorial Hospital Inc | Current |
Accepting new patients | |
| Tomah Memorial Hospital Inc | Current |
Accepting new patients |
Locations
501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181
Interoperability endpoints
- mlanepeot635080@direct.emplifyhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 17025-33 | WI | Yes |
Addresses
Primary practice location
501 Gopher Dr
Tomah, WI 54660-4513
Mailing address
902 W Veterans St
Tomah, WI 54660-2903
Phone (608) 343-2443
Other providers in Tomah, WI
- L&P Services LLC
- Sarah Labeause
- Arthur Allen Laberge II
- James Randall Lacy
- Colleen Laflamme
- Douglas John Lanska
- Maryjo Lanska
- David P Larsen
- Erik Paul Logen Larsen
- Kayleen Raye Larson
All providers in Tomah, WI · Family Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.