Individual provider Active NPI

Douglas Todd Laluzerne, PT

  • Physical Therapist
  • Green Bay, WI
National Provider Identifier
1992978027
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14031-24 Issued in WI
Practice address
3263 Eaton Rd
Green Bay, WI 54311
Phone
(920) 433-6700
Fax
(920) 433-6719
NPI assigned
Apr 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14031-24 WI Primary

Addresses

Primary practice location

3263 Eaton Rd
Green Bay, WI 54311

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7226

Other practice location 1

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-7822

Other practice location 2

405 Commercial St
Seymour, WI 54165-8474
Phone (920) 833-2318

Other practice location 3

1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4750

Other practice location 4

1800 Lawrence Dr
DE Pere, WI 54115-9108
Phone (920) 983-3220

Other practice location 5

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone (920) 430-4888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171215000312 WI Practitioner - Physical Therapist in Private Practice 5294093555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
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)

3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14031-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc CurrentSince Jul 23, 2019 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Nov 1, 2017 Accepting new patients
Bellin Memorial Hospital Inc Physical Therapist CurrentSince Nov 1, 2017 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jul 23, 2019 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

2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817

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

1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700

3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

405 Commercial St
Seymour, WI 54165
Phone (920) 833-2318

Interoperability endpoints

  • Direct secure messaging: dlaluzerne183269@direct.thedacare.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1992978027",
    "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": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3263 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-433-7822",
            "fax_number": "920-433-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Commercial St",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "WI",
            "postal_code": "541658474",
            "country_code": "US",
            "telephone_number": "920-833-2318",
            "fax_number": "920-833-6883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135753",
            "country_code": "US",
            "telephone_number": "920-430-4750",
            "fax_number": "920-430-4746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Lawrence Dr",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541159108",
            "country_code": "US",
            "telephone_number": "920-983-3220",
            "fax_number": "920-983-3226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1970 S Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543044125",
            "country_code": "US",
            "telephone_number": "920-430-4888",
            "fax_number": "920-430-4889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LALUZERNE",
        "first_name": "DOUGLAS",
        "middle_name": "TODD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14031-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.