Individual provider Active NPI

Laurie A Nielsen-Haak, DPM

  • Foot & Ankle Surgery Podiatrist
  • Sidney, OH
National Provider Identifier
1356346308
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36-00-3195-N Issued in OH
Practice address
915 Michigan St Ste 100
Sidney, OH 45365-2401
Phone
(937) 419-8049
Fax
(937) 419-8050
NPI assigned
Jun 16, 2005
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36-00-3195-N OH Primary

Addresses

Primary practice location

915 Michigan St Ste 100
Sidney, OH 45365-2401

Mailing address

915 Michigan St Ste 100
Sidney, OH 45365-2401
Phone (937) 419-8049

Other identifiers 2

IdentifierTypeStateIssuer
2304303MedicaidOH
P00248977OtherOHMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317000057 OH Practitioner - Podiatry 6406746239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilson Care, LLCGroup PAC ID 4385549666, 58 clinicians

Practice addresses (Care Compare)

915 Michigan St
Suite 100
Sidney, OH 45365-2401
Phone 93749459880000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.07 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
81.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue53
Removal of nail tissue268
Removal or shaving of skin growth41
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Care, LLC Foot & Ankle Surgery CurrentSince Jan 30, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Dixie a. Dooley, DPM, Inc. Foot & Ankle Surgery Past Accepting new patients

Locations

915 Michigan St
Sidney, OH 45365
Phone (937) 498-2311

915 Michigan St
Ste 100
Sidney, OH 45365
Phone (937) 419-8049

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/107/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lnielsenhaak1537912@direct.osumc.edu

Organizations & group practices 3

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 1

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1356346308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MICHIGAN ST STE 100",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652401",
            "telephone_number": "937-419-8049",
            "fax_number": "937-419-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MICHIGAN ST STE 100",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652401",
            "telephone_number": "937-419-8049",
            "fax_number": "937-419-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN-HAAK",
        "first_name": "LAURIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-07-13",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36-00-3195-N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2304303",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00248977",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

Verify at the official NPI Registry.