Individual provider Active NPI

Leesa Ann McShane, A.P.N.P.

  • Family Nurse Practitioner
  • Markesan, WI
National Provider Identifier
1629302187
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3836-033 Issued in WI
Practice address
730 N Margaret St
Markesan, WI 53946-8688
Phone
(920) 398-2406
Fax
(920) 398-3766
NPI assigned
Sep 30, 2009
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3836-033 WI Primary

Addresses

Primary practice location

730 N Margaret St
Markesan, WI 53946-8688

Mailing address

420 E Division St
Fon Du Lac, WI 54935-4560
Phone (920) 926-8340

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lmcshane331549@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
I20091014000128 WI Practitioner - Nurse Practitioner 3375689821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
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)

730 N Margaret St
Markesan, WI 53946-8688
Phone (920) 398-2406

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3836-033WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 1, 2018 Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 1, 2018 Accepting new patients
Jeffrey G. Bentson, M.D., PLLC Past Accepting new patients

Locations

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

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

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

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

730 N Margaret St
Markesan, WI 53946
Phone (920) 398-2406

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

Organizations & group practices 4

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 5

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": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1629302187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FON DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8340",
            "fax_number": "920-926-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N MARGARET ST",
            "city": "MARKESAN",
            "state": "WI",
            "postal_code": "539468688",
            "telephone_number": "920-398-2406",
            "fax_number": "920-398-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSHANE",
        "first_name": "LEESA",
        "middle_name": "ANN",
        "credential": "A.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "3836-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmcshane331549@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lmcshane331549@direct-ehr-ssmhc.com",
            "address_1": "730 N Margaret St",
            "city": "Markesan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539468688",
            "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": "730 N Margaret St",
            "city": "Markesan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539468688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Markesan, WI

Sources for this page

Verify at the official NPI Registry.