NPIMap

Individual provider Active NPI

Stacee Lynn Goedtel Birr, DO

  • Family Medicine Physician
  • Appleton, WI
National Provider Identifier
1295152189
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
65320-21 Issued in WI
Practice address
229 S Morrison St
Appleton, WI 54911-5725
Phone
(920) 832-2783
Fax
(920) 832-2635
NPI assigned
Mar 28, 2014
Last updated
Jun 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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
Family Medicine Physician 207Q00000X 65320-21 WI Primary

Addresses

Primary practice location

229 S Morrison St
Appleton, WI 54911-5725

Mailing address

853 S Main St
Oconto Falls, WI 54154
Phone (920) 496-4700

Other names 1

  • Dr. Stacee Lynn Goedtel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171017002770 WI Practitioner - Family Practice 9830465939 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Clare Memorial Hospital, IncGroup PAC ID 0446211395, 62 clinicians

Practice addresses (Care Compare)

835 S Main St
Oconto Falls, WI 54154-1282

853 S Main St
Oconto Falls, WI 54154-1203
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Oct 2, 2017 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Family Medicine CurrentSince Oct 2, 2017 Accepting new patients
Prevea Clinic, Inc. Family Medicine Current Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Oct 2, 2017 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Nov 15, 2017 Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince Nov 15, 2017 Accepting new patients
St Clare Memorial Hospital, Inc. Past Accepting new patients
St Clare Memorial Hospital, Inc Family Medicine Past Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

835 S Main St
Oconto Falls, WI 54154
Phone (920) 846-0509

835 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-4864

853 S Main St
Oconto Falls, WI 54154
Phone (920) 846-4680

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
HSHS St. Clare Memorial HospitalOconto Falls, WI, CCN 521310 Hospital Corporate Director Nov 1, 2023
HSHS St Clare Memorial HospitalOconto Falls, WI, CCN 52Z310 Hospital Corporate Director Nov 1, 2023
Meadowbrook at Oconto FallsOconto Falls, WI, CCN 525449 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 22, 2016
Mar 22, 2016
HSHS St. Clare Memorial HospitalSuring, WI, CCN 528547 Rural health clinic Corporate Director Nov 1, 2023
HSHS St. Clare Memorial HospitalLena, WI, CCN 528544 Rural health clinic Corporate Director Nov 1, 2023
HSHS St. Clare Memorial HospitalMountain, WI, CCN 528545 Rural health clinic Corporate Director Nov 1, 2023
HSHS St. Clare Memorial HospitalGillett, WI, CCN 528542 Rural health clinic Corporate Director Nov 1, 2023

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1295152189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 S MAIN ST",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "54154",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S MORRISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115725",
            "telephone_number": "920-832-2783",
            "fax_number": "920-832-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDTEL BIRR",
        "first_name": "STACEE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "65320-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEE",
            "last_name": "GOEDTEL",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.