Active NPI
Laura Peck
- Surgery Physician
- Two Rivers, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 5101025446
- Practice address
- 5300 Memorial Dr
Two Rivers, WI 54241-3923 - Phone
- (920) 793-7300
- NPI assigned
- Jul 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5101025446 | MI | Primary |
| Surgery Physician | 208600000X | TL.005462 | CO |
Addresses
Primary practice location
5300 Memorial Dr
Two Rivers, WI 54241-3923
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
501 E Hampden Ave
Englewood, CO 80113-2702
Phone (954) 515-6056
Other practice location 2
29000 Little Mack Ave Ste B
Saint Clair Shores, MI 48081-3018
Phone (586) 774-8811
Other practice location 3
515 E Grant St Ste 211
Macomb, IL 61455-3378
Phone (309) 833-3706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100308760 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lpeck422553@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WI, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Nova Southeastern College of Osteo Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5300 Memorial Dr
Two Rivers, WI 54241-3923
Phone (920) 793-7300
Hospital & facility affiliations
- Aurora Medical Ctr Manitowoc County
- Aurora Medical Center Bay Area
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TL.005462 | CO | MD | Surgery Physician |
| 5101025446 | MI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McDonough County Hospital District | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
503 E Grant St
Macomb, IL 61455
Phone (309) 833-5917
515 E Grant St
Ste 211
Macomb, IL 61455
Phone (309) 833-3706
515 E Grant St
Ste 112
Macomb, IL 61455
Phone (309) 833-4104
859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271
1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201
1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192
900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500
100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100
Dept 2269
Tulsa, OK 74182
27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
5300 Memorial Dr
Two Rivers, WI 54241
Phone (920) 793-7300
Interoperability endpoints
- lpeck422553@direct.myadvocateaurora.org
Organizations & group practices 10
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Internal Medicine Physician
- Macomb, IL
- NPI 1609180082
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Public Health or Welfare Agency
- Tahlequah, OK
- NPI 1013884154
-
- Multi-Specialty Clinic/Center
- Salina, OK
- NPI 1326054081
-
- Multi-Specialty Clinic/Center
- Muskogee, OK
- NPI 1841207156
-
- Community/Retail Pharmacy
- Macomb, IL
- NPI 1245098458
-
- Anatomic Pathology & Clinical Pathology Physician
- Macomb, IL
- NPI 1396055869
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Two Rivers, WI
- NPI 1477508687
-
- General Acute Care Hospital
- Marinette, WI
- NPI 1043397177
-
- Clinical Medical Laboratory
- Marinette, WI
- NPI 1083791115
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745971200000",
"number": "1699159558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 MEMORIAL DR",
"city": "TWO RIVERS",
"state": "WI",
"postal_code": "542413923",
"telephone_number": "920-793-7300"
}
],
"practiceLocations": [
{
"address_1": "501 E Hampden Ave",
"address_purpose": "LOCATION",
"city": "Englewood",
"state": "CO",
"postal_code": "801132702",
"country_code": "US",
"telephone_number": "954-515-6056",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "29000 Little Mack Ave Ste B",
"address_purpose": "LOCATION",
"city": "Saint Clair Shores",
"state": "MI",
"postal_code": "480813018",
"country_code": "US",
"telephone_number": "586-774-8811",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "515 E Grant St Ste 211",
"address_purpose": "LOCATION",
"city": "Macomb",
"state": "IL",
"postal_code": "614553378",
"country_code": "US",
"telephone_number": "309-833-3706",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PECK",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-09",
"last_updated": "2025-04-30",
"certification_date": "2025-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "5101025446",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CO",
"license": "TL.005462",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100308760",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lpeck422553@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "5300 Memorial Dr",
"city": "Two Rivers",
"state": "WI",
"country_code": "US",
"postal_code": "542413923",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "5300 Memorial Dr",
"city": "Two Rivers",
"state": "WI",
"country_code": "US",
"postal_code": "542413923",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Two Rivers, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.