Individual provider Active NPI

Lydia Marie Mootz, PA-C

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1386299402
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4848-23 Issued in WI
Practice address
700 S Park St Ste a
Madison, WI 53715-1830
Phone
(608) 260-2900
Fax
(608) 260-2961
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 4848-23 WI Primary

Addresses

Primary practice location

700 S Park St Ste a
Madison, WI 53715-1830

Mailing address

700 S Park St Ste a
Madison, WI 53715-1830
Phone (608) 260-2900

Other identifiers 1

IdentifierTypeStateIssuer
1386299402MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address lcaldwell271871@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 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
I20190918000645 WI Practitioner - Physician Assistant 7618207648 Reassigns benefits to 3 organizations
I20260401000806 IL Practitioner - Physician Assistant 7618207648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone (715) 423-6060

420 Dewey St
Wisconsin Rapids, WI 54494-4714
Phone (715) 422-7750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4848-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Mar 25, 2025 Accepting new patients
Dean Health Systems, Inc CurrentSince Mar 9, 2021 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Apr 17, 2025 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Mar 25, 2025 Accepting new patients
Dean Health Systems, Inc. CurrentSince Mar 9, 2021 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

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

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

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

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Interoperability endpoints

  • Direct secure messaging: lcaldwell271871@direct-ehr-ssmhc.com
  • Direct secure messaging: lcaldwell360625@direct.aspirus.org

Organizations & group practices 7

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1386299402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST STE A",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST STE A",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOTZ",
        "first_name": "LYDIA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4848-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386299402",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "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 Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcaldwell271871@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lcaldwell271871@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St Ste A",
            "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.