Individual provider Active NPI

Laura M Stebnitz, PA-C

  • Physician Assistant
  • Green Bay, WI
National Provider Identifier
1538487558
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2594-23 Issued in WI
Practice address
744 S Webster Ave
Green Bay, WI 54301-3505
Phone
(920) 433-3500
NPI assigned
May 14, 2010
Last updated
Oct 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 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 2594-23 WI Primary

Addresses

Primary practice location

744 S Webster Ave
Green Bay, WI 54301-3505

Mailing address

744 S Webster Ave
Green Bay, WI 54301-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 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
I20100708000550 WI Practitioner - Physician Assistant 1759412711 Reassigns benefits to 4 organizations
I20220210000235 MI Practitioner - Physician Assistant 1759412711 Reassigns benefits to 1 organization

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
New Dermatology Group LTDGroup PAC ID 9537312665, 23 clinicians

Practice addresses (Care Compare)

1606 S Stephenson Ave
Iron Mountain, MI 49801-3636
Phone (920) 965-0345

2360 Duck Creek Pkwy
Green Bay, WI 54303-3300
Phone (920) 965-0345

3059 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 965-0345

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2594-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc CurrentSince Dec 10, 2012 Accepting new patients
Oconto Hospital & Medical Center Inc Physician Assistant CurrentSince Dec 10, 2012 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jun 28, 2010 Accepting new patients
New Dermatology Group LTD Past Accepting new patients

Locations

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

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

307 Manor Dr
Suring, WI 54174
Phone (920) 842-2144

Interoperability endpoints

  • Direct secure messaging: laura.stebnitz.1@23194.direct.athenahealth.com

Organizations & group practices 8

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 1

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": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1538487558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEBNITZ",
        "first_name": "LAURA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2594-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.