David Jude Lenz, MD – Internal Medicine Physician

Key facts

NPI: 1528089034
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 25979 (WI)
Practice address: W3395 Appaloosa CT
Freedom, WI 54913-8076
Phone: (920) 739-1323
NPI assigned: Jul 21, 2006
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20130729000808	WI	Practitioner - Internal Medicine	8921248360

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
25979	WI	MD	Internal Medicine Physician

Interoperability endpoints

Direct secure messaging: dlenz6405@direct.thedacare.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X	25979	WI	Yes

Addresses

Primary practice location

W3395 Appaloosa CT
Freedom, WI 54913-8076

Mailing address

W3395 Appaloosa CT
Freedom, WI 54913-8076
Phone (920) 739-1323

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 29, 2021.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1528089034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3395 APPALOOSA CT",
            "city": "FREEDOM",
            "state": "WI",
            "postal_code": "549138076",
            "telephone_number": "920-739-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3395 APPALOOSA CT",
            "city": "FREEDOM",
            "state": "WI",
            "postal_code": "549138076",
            "telephone_number": "920-739-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZ",
        "first_name": "DAVID",
        "middle_name": "JUDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-09-29",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "25979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freedom, WI

All providers in Freedom, WI · Internal Medicine Physician in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.