NPIMap

Individual provider Active NPI

Janet Richlen, PA-C

  • Physician Assistant
  • Lena, WI
National Provider Identifier
1366411993
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1428-023 Issued in WI
Practice address
200 Rosera St
Lena, WI 54139-9169
Phone
(920) 829-6400
Fax
(920) 829-6403
NPI assigned
Mar 16, 2006
Last updated
Mar 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1428-023 WI Primary

Addresses

Primary practice location

200 Rosera St
Lena, WI 54139-9169

Mailing address

200 S Rosera St
Lena, WI 54139-9169
Phone (920) 829-6400

Other identifiers 4

IdentifierTypeStateIssuer
11014110MedicaidWI
41969700MedicaidWI
1851477913OtherWICMH NPI
1346371358OtherWILENA PCC NPI

Other names 1

  • Ms. Janet Luccarini 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
I20060901000065 WI Practitioner - Physician Assistant 1355345430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 2002
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)

1409 Cleveland Ave
Marinette, WI 54143-3918
Phone (920) 496-4700

1601 Lawrence Dr
Suite 100
De Pere, WI 54115-3931
Phone (920) 496-4700

200 S Rosera St
Lena, WI 54139-9169
Phone (920) 829-6400

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

913 Main St
Suring, WI 54174-9012
Phone (920) 842-1147

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1428-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Clare Memorial Hospital, Inc. CurrentSince Jun 24, 2010 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Feb 11, 2017 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Feb 11, 2017 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Jun 24, 2010 Accepting new patients
Community Memorial Hospital, Incorporated Past Accepting new patients
St Clare Memorial Hospital, Inc Past Accepting new patients
Community Memorial Hospital, Incorporated Past Accepting new patients
St Clare Memorial Hospital, Inc Physician Assistant Past Accepting new patients
Community Memorial Hospital Past Accepting new patients
Community Memorial Hospital, Incorporated Past Accepting new patients

Locations

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

200 S Rosera St
Lena, WI 54139
Phone (920) 829-6400

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

Interoperability endpoints

  • FHIR API: https://eprescribe.sanfordhealth.org/FHIR/api/FHIR/R4/

Organizations & group practices 10

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 5

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1366411993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S ROSERA ST",
            "city": "LENA",
            "state": "WI",
            "postal_code": "541399169",
            "telephone_number": "920-829-6400",
            "fax_number": "920-829-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ROSERA ST",
            "city": "LENA",
            "state": "WI",
            "postal_code": "541399169",
            "telephone_number": "920-829-6400",
            "fax_number": "920-829-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHLEN",
        "first_name": "JANET",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1428-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11014110",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41969700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMH NPI",
            "identifier": "1851477913",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LENA PCC NPI",
            "identifier": "1346371358",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "LUCCARINI",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lena, WI

Sources for this page

Verify at the official NPI Registry.