Lydia R Emnott, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7148 Issued in WI

Practice address

2654 S Oneida St
Ste 102
Green Bay, WI 54304-5330

Phone

(888) 938-3838

Fax

(888) 919-1083

NPI assigned

Jan 19, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Mercy College, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Ear Nose and Throat Specialists, SCGroup PAC ID 9335106319, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22900/brand/1/csg/21/fhir/r4

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.

• Advanced Ear Nose & Throat Specialists, SC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Milwaukee, WI
  • NPI 1689782427
  Medicare reassignment Care Compare group
• Advanced Ear Nose & Throat Specialists, SC

  • Otolaryngology Physician
  • Miamisburg, OH
  • NPI 1811717887
  NPD
• Lexington Medical Associates PC

  • Family Medicine Physician
  • New York, NY
  • NPI 1417119538
  NPD (past)

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821393000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2654 S ONEIDA ST",
            "address_2": "STE 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045330",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMNOTT",
        "first_name": "LYDIA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2023-03-07",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014440",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS PHYSICIAN ASSISTANT LICENSE",
            "identifier": "014440",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LICENSE",
            "identifier": "7148",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Embodied-Wellbeing Limited Liability Company
• Embodied-Welllbeing
• Tucker Anthony Emerson, D.C.
• Kate Henniges Emme, SLP
• Ethan Errol Emmons, MD
• Emplify Health Behavioral Health
• Employment Health Services, LLC
• Encore Wisconsin LLC
• Endocrinology Associates of Green Bay SC
• Engage Orthodontics-Hanson SC

• Physician Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.

Verify at the official NPI Registry.