Individual provider Active NPI

Luke P Lentscher, PA-C

  • Surgical Physician Assistant
  • Beaver Dam, WI
National Provider Identifier
1609065085
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3061-23 Issued in WI
Practice address
250 Corporate Dr
Beaver Dam, WI 53916
Phone
(920) 887-6650
NPI assigned
Oct 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085003078 IL
Surgical Physician Assistant 363AS0400X 3061-23 WI Primary

Addresses

Primary practice location

250 Corporate Dr
Beaver Dam, WI 53916

Mailing address

420 E Division St
Fond Du Lac, WI 54935-4560

Other practice location 1

100 Spalding Dr
3rd Floor
Naperville, IL 60540-6550
Phone (630) 355-8000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address llentscher331539@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130606000577 WI Practitioner - Physician Assistant 9032293287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

130 Corporate Dr
Beaver Dam, WI 53916-3116
Phone (920) 887-3102

360 S Mountin Dr
Mayville, WI 53050-1498
Phone (920) 387-2111

608 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6800

620 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6531

Hospital & facility affiliations

  • Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327
  • SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3061-23WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Physician Practices LLC CurrentSince Aug 1, 2016 Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 6, 2018 Accepting new patients
Watertown Physician Practices LLC CurrentSince Aug 1, 2016 Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 6, 2018 Accepting new patients
Agnesian Healthcare, Inc Past Accepting new patients

Locations

130 Corporate Dr
Beaver Dam, WI 53916
Phone (920) 877-3102

250 Corporate Dr
Beaver Dam, WI 53916
Phone (920) 887-6650

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

145 N Main St
Fond du Lac, WI 54935
Phone (920) 926-4660

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

835 Parkside St
Ripon, WI 54971
Phone (920) 745-3520

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

608 W Brown St
Waupun, WI 53963
Phone (920) 324-6800

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 3

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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1609065085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CORPORATE DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "53916",
            "telephone_number": "920-887-6650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Spalding Dr",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605406550",
            "country_code": "US",
            "telephone_number": "630-355-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENTSCHER",
        "first_name": "LUKE",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085003078",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "3061-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llentscher331539@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "llentscher331539@direct-ehr-ssmhc.com",
            "address_1": "250 Corporate Dr",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "250 Corporate Dr",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

Verify at the official NPI Registry.