Individual provider Active NPI

Lea Ann Schroeter, MD

  • Pediatrics Physician
  • Hurley, WI
National Provider Identifier
1699773887
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301050609 Issued in MI
Practice address
501 Granite St
Hurley, WI 54534-1384
Phone
(715) 561-2255
Fax
(715) 561-5021
NPI assigned
Jul 12, 2005
Last updated
Sep 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301050609 MI Primary
Pediatrics Physician 208000000X 26178 WI

Addresses

Primary practice location

501 Granite St
Hurley, WI 54534-1384

Mailing address

N10565 Grandview LN
Ironwood, MI 49938-9622
Phone (906) 932-1500

Other identifiers 5

IdentifierTypeStateIssuer
4307534MedicaidMI
30735100MedicaidWI
1018466OtherPREFERREDONE
12D82SCOtherMNBCBS
LS050609OtherMIBLUE CROSS BLUE SHIELD MI

Other names 1

  • Leaann Schroeter Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040927001101 WI Practitioner - Pediatric Medicine 8022917061 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301050609MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Oct 14, 2013 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Nov 9, 2012 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Nov 9, 2012 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Oct 14, 2013 Accepting new patients
Memorial Medical Center Inc CurrentSince Aug 30, 2016 Accepting new patients
Memorial Medical Center Inc CurrentSince Aug 30, 2016 Accepting new patients
Gundersen Clinic LTD CurrentSince Oct 14, 2013 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Oct 14, 2013 Accepting new patients
Vickers Eyecare, Inc PastSince Jul 1, 2020 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1699773887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N10565 GRANDVIEW LN",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499389622",
            "telephone_number": "906-932-1500",
            "fax_number": "906-932-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GRANITE ST",
            "city": "HURLEY",
            "state": "WI",
            "postal_code": "545341384",
            "telephone_number": "715-561-2255",
            "fax_number": "715-561-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROETER",
        "first_name": "LEA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301050609",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "26178",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4307534",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30735100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1018466",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12D82SC",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "LS050609",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAANN",
            "last_name": "SCHROETER",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hurley, WI

Sources for this page

Verify at the official NPI Registry.