Individual provider Active NPI

Levi Jon Lawry-Shefchik

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1265165682
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7961-23 Issued in WI
Practice address
700 S Park St
Madison, WI 53715-1830
Phone
(608) 260-2900
Fax
(608) 260-2976
NPI assigned
Jul 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 7961-23 WI Primary

Addresses

Primary practice location

700 S Park St
Madison, WI 53715-1830

Mailing address

422 Lush Woods TRL
Verona, WI 53593-8169
Phone (608) 235-2260

Other practice location 1

422 Lush Woods Trl
Verona, WI 53593-8169
Phone (608) 235-2260

Other identifiers 1

IdentifierTypeStateIssuer
1265165682MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address llawryshefchik377255@direct-ehr-ssmh.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241008002608 WI Practitioner - Physician Assistant 4981135449 Reassigns benefits to 1 organization
I20250523001658 AZ Practitioner - Physician Assistant 4981135449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

1900 N Higley Rd
Banner Health Clinic
Gilbert, AZ 85234-1604
Phone (480) 543-2688

1920 N Higley Rd
Gilbert, AZ 85234-1625

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 1, 2025 Accepting new patients
Dean Health Systems, Inc CurrentSince Sep 25, 2024 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 1, 2025 Accepting new patients
Dean Health Systems, Inc. CurrentSince Sep 25, 2024 Accepting new patients
Banner Physician Specialists Arizona LLC Past Accepting new patients

Locations

1920 N Higley Rd
Ste 306
Gilbert, AZ 85234
Phone (480) 543-2606

1920 N Higley Rd
Ste 308
Gilbert, AZ 85234
Phone (480) 543-6600

6553 E Baywood Ave
Ste 101
Mesa, AZ 85206
Phone (480) 543-6750

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1656892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1265165682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 LUSH WOODS TRL",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535938169",
            "telephone_number": "608-235-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "422 Lush Woods Trl",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "WI",
            "postal_code": "535938169",
            "country_code": "US",
            "telephone_number": "608-235-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRY-SHEFCHIK",
        "first_name": "LEVI",
        "middle_name": "JON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-04",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7961-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265165682",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llawryshefchik377255@direct-ehr-ssmh.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "llawryshefchik377255@direct-ehr-ssmh.com",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.