NPIMap

Individual provider Active NPI

Lindsey Wilson Kulbacki, PA-C

  • Physician Assistant
  • Appleton, WI
National Provider Identifier
1417268723
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2613-23 Issued in WI
Practice address
2500 E Capitol Dr
Appleton, WI 54911-8735
Phone
(920) 364-3000
Fax
(920) 364-3900
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 2613-23 WI Primary

Addresses

Primary practice location

2500 E Capitol Dr
Appleton, WI 54911-8735

Mailing address

122 E College Ave
Appleton, WI 54911-5794
Phone (920) 996-3264

Other practice location 1

333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 364-3600

Other practice location 2

1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 435-8326 ext. 5134

Other practice location 3

1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 435-8326 ext. 5134

Other identifiers 1

IdentifierTypeStateIssuer
2613-23OtherWIWISCONSIN STATE LICENSE

Other names 1

  • Ms. Lindsey Ann Wilson 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
I20130122000478 WI Practitioner - Physician Assistant 3779736970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1818 N Meade St
Appleton, WI 54911-3454

1818 N Meade St Room
N255
Appleton, WI 54911-3454
Phone (920) 730-3383

2005 Midway Rd
Menasha, WI 54952-7002
Phone (920) 832-8500

206 S Mill St
Weyauwega, WI 54983-9365
Phone (920) 720-2300

2500 E Capital Dr
Appleton, WI 54911-8735

3 Neenah Ctr
Neenah, WI 54956-3070

333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 720-2300

4480 W Spencer St
Appleton, WI 54915
Phone (920) 738-4800

491 S Washburn St
Suite 100
Oshkosh, WI 54904-6733
Phone (920) 292-5555

600 N Westhaven Dr
Oshkosh, WI 54904-6926
Phone (920) 725-0077

900 E Grant St
Thedacare Orthopedic Care
Appleton, WI 54911-3454
Phone (920) 831-5050

W5282 Amy Ave
Appleton, WI 54915-7233
Phone (920) 358-1900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2613-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Dec 3, 2012 Accepting new patients
Bellin Memorial Hospital CurrentSince Dec 3, 2012 Accepting new patients
Thedacare, Incorporated CurrentSince Oct 1, 2017 Accepting new patients
Thedacare, Incorporated CurrentSince Oct 1, 2017 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 738-4600

122 E College Ave
Appleton, WI 54911
Phone (920) 996-3264

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

1580 Commanche Ave
Green Bay, WI 54313
Phone (920) 431-5687

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

333 N Green Bay Rd
Neenah, WI 54956
Phone (920) 725-2070

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: lkulbacki183210@direct.thedacare.org

Organizations & group practices 6

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 12

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417268723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115794",
            "telephone_number": "920-996-3264",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E CAPITOL DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118735",
            "telephone_number": "920-364-3000",
            "fax_number": "920-364-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549561954",
            "country_code": "US",
            "telephone_number": "920-364-3600",
            "fax_number": "920-634-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1580 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135751",
            "country_code": "US",
            "telephone_number": "920-435-8326 x5134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1580 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135751",
            "country_code": "US",
            "telephone_number": "920-435-8326 x5134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULBACKI",
        "first_name": "LINDSEY",
        "middle_name": "WILSON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2613-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN STATE LICENSE",
            "identifier": "2613-23",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "WILSON",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.