Lisa Marie Draeger, OTR
Individual provider Active NPI Occupational Therapist · Jackson, WI
NPI 1245404995 · NPPES record last updated Apr 14, 2008
Key facts
- NPI
- 1245404995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 3540-026 (WI)
- Practice address
- N163W19787 Riverview Dr
Jackson, WI 53037-8904 - Phone
- (262) 677-0132
- NPI assigned
- Apr 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 15
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Froedtert Andthe Medical College of Wisconsin Community Physicians Inc
Practice addresses (Care Compare)
3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110217000873 | WI | Practitioner - Occupational Therapist in Private Practice | 7113108531 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3540-026 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Current | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current |
Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current |
Accepting new patients |
Locations
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
110 Lone Oak Ln
Hartford, WI 53027
Phone (262) 670-1800
1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533
1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3540-026 | WI | Yes |
Addresses
Primary practice location
N163W19787 Riverview Dr
Jackson, WI 53037-8904
Mailing address
N163W19787 Riverview Dr
Jackson, WI 53037-8904
Phone (262) 677-0132
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40833500 | Medicaid | WI |
Other providers in Jackson, WI
- Children'S Medical Group
- Gregory A. Claypool
- Stacey L Davison
- Abigail Lee Deming
- Jane A Dixon
- Heather S Dykema
- Scott McLean Foley
- Froedtert & the Medical College of Wisconsin Community Physicians Inc
- Traci Gibb
- Great Horizon Transportation LLC
All providers in Jackson, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2008. 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.
- 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.