Individual provider Active NPI

Cynthia B Lasecki, MD

  • Family Medicine Physician
  • De Pere, WI
National Provider Identifier
1871577577
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38248 Issued in WI
Practice address
1800 Lawrence Dr
De Pere, WI 54115-9108
Phone
(920) 983-3220
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38248 WI Primary

Addresses

Primary practice location

1800 Lawrence Dr
De Pere, WI 54115-9108

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

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
I20100520000182 WI Practitioner - Family Practice 8729117353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-6025

Hospital & facility affiliations

  • Unity Hospice Hospice, De Pere, WI, CCN 521503
  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Jan 15, 2011 Accepting new patients
Bellin Memorial Hospital Inc Family Medicine Current Accepting new patients
Bellin Memorial Hospital Inc Family Medicine CurrentSince Jan 15, 2011 Accepting new patients
Bellin Memorial Hospital Inc Family Medicine Past Accepting new patients

Locations

1800 Lawrence Dr
De Pere, WI 54115
Phone (920) 983-3220

555 Redbird Cir
De Pere, WI 54115
Phone (920) 338-6820

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

Interoperability endpoints

  • Direct secure messaging: clasecki32408@direct.thedacare.org
  • Direct secure messaging: clasecki924913@direct.emplifyhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1871577577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159108",
            "telephone_number": "920-983-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASECKI",
        "first_name": "CYNTHIA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "38248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.