Individual provider Active NPI

Lynn Marie Budzak, MD

  • Adult Medicine Physician
  • Green Bay, WI
National Provider Identifier
1780603589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
32421-020 Issued in WI
Practice address
141 Siegler St
Green Bay, WI 54303-2635
Phone
(920) 497-3126
Fax
(920) 497-3176
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 32421-020 WI Primary

Addresses

Primary practice location

141 Siegler St
Green Bay, WI 54303-2635

Mailing address

141 Siegler St
Green Bay, WI 54303-2635
Phone (920) 497-3126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20120629000280 IN Order and Referring Only - Family PracticePractitioner - Family Practice 4789849522

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32421-020WIMDAdult Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780603589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 SIEGLER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032635",
            "telephone_number": "920-497-3126",
            "fax_number": "920-497-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SIEGLER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032635",
            "telephone_number": "920-497-3126",
            "fax_number": "920-497-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDZAK",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "WI",
            "license": "32421-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.