Individual provider Active NPI

Stephen Lo, MD

  • Pediatrics Physician
  • Fitchburg, WI
National Provider Identifier
1407875206
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
36986 Issued in WI
Practice address
3051 Cahill Main
Fitchburg, WI 53711-7109
Phone
(608) 661-7200
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 36986 WI Primary

Addresses

Primary practice location

3051 Cahill Main
Fitchburg, WI 53711-7109

Mailing address

1265 John Q Hammons Dr
Madison, WI 53717-1941
Phone (608) 251-4156

Other identifiers 1

IdentifierTypeStateIssuer
32381300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130723000852 WI Practitioner - Family PracticePractitioner - Pediatric Medicine 7618118357 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36986WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince May 6, 2013 Accepting new patients

Locations

3051 Cahill Main
Fitchburg, WI 53711
Phone (608) 257-9700

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

1265 John Q Hammons Dr
Madison, WI 53717

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1407875206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 JOHN Q HAMMONS DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171941",
            "telephone_number": "608-251-4156",
            "fax_number": "608-257-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 CAHILL MAIN",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537117109",
            "telephone_number": "608-661-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "36986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32381300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

Verify at the official NPI Registry.