Lucas Jerry Schwartz, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6001026 Issued in WI

Practice address

214 Larkin St
Tomah, WI 54660-1194

Phone

(608) 372-3298

NPI assigned

Jun 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 22, 2022 through Jul 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of Monroe

  • Skilled Nursing Facility
  • Sparta, WI
  • NPI 1952306748
  NPD (past)
• Tomah Family Dentistry LLC

  • General Practice Dentistry
  • Tomah, WI
  • NPI 1558476184
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1669101507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24253 LINDEN AVE",
            "city": "WILTON",
            "state": "WI",
            "postal_code": "546708706",
            "telephone_number": "608-387-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 LARKIN ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601194",
            "telephone_number": "608-372-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "LUCAS",
        "middle_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Becca Schroepfer, LISW
• Charli Schueler, RN
• Halle Jo Schueler, RN
• Alyssa Schultz
• Penny Jo Schultz, NURSE PRACTITIONER
• Renee Schwartz
• Darlene K Seaman, RN
• Michael Joseph Seehafer, REGISTERED NURSE
• Heidi Seidel
• Richard Paul Sendejo, LPC

• General Practice Dentistry in Tomah, WI
• Providers in Tomah, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.