Mr Lee A Cleveland, RD CDE is a medicare enrolled "Dietitian, Registered" provider in Menasha, Wisconsin. He graduated from medical school in 1998 and has 26 years of diverse experience with area of expertise as Registered Dietitian Or Nutrition Professional. He is a member of the group practice Ascension Medical Group-fox Valley Wisconsin Inc and his current practice location is
1550 Midway Pl, Menasha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 585-4961.
Mr Lee A Cleveland is licensed to practice in Wisconsin (license number 1864) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1295722957.
Healthcare Provider's Profile
| Full Name | Mr Lee A Cleveland |
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| Gender | Male |
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| Speciality | Registered Dietitian Or Nutrition Professional |
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| Experience | 26 Years |
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| Location | 1550 Midway Pl, Menasha, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Lee A Cleveland graduated from medical school in 1998
NPI Data:
- NPI Number: 1295722957
- Provider Enumeration Date: 09/28/2005
- Last Update Date: 04/23/2013
Medicare PECOS Information:
- PECOS PAC ID: 8224063268
- Enrollment ID: I20050928001280
Medical Identifiers
Medical identifiers for Mr Lee A Cleveland such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295722957 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 1864 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Ascension Medical Group-fox Valley Wisconsin Inc | 0244142420 | 240 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Lee A Cleveland allows following entities to bill medicare on his behalf.
| Provider Name | Ascension Medical Group-fox Valley Wisconsin Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1730126392
PECOS PAC ID: 0244142420
Enrollment ID: O20031105000351 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Lee A Cleveland is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Lee A Cleveland, RD CDE
W5008 Golf Course Rd, #604,
Sherwood, WI 54169-9723
Ph: (920) 585-4961 | Mr Lee A Cleveland, RD CDE
1550 Midway Pl,
Menasha, WI 54952-1165
Ph: (920) 585-4961 |
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