Jeremy R Luedtke, MD | |
400 Legacy Plz W, La Porte, IN 46350-5296 | |
(219) 379-3166 | |
(219) 324-9730 |
Full Name | Jeremy R Luedtke |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 18 Years |
Location | 400 Legacy Plz W, La Porte, Indiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891900783 | NPI | - | NPPES |
07028 | Other | WI | MEDICARE # |
300008363 | Medicaid | IN | |
IN2920085 | Other | IN | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 4301087609 (Michigan) | Secondary |
208600000X | Surgery | 57033-20 (Wisconsin) | Secondary |
208600000X | Surgery | 01079264A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Thedacare Medical Center - Shawano | Shawano, WI | Hospital |
Thedacare Regional Med Ctr - Neenah | Neenah, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Surgical Associates Of Neenah, S.c. | 4486625258 | 27 |
Entity Name | Thedacare, Incorporated |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376656959 PECOS PAC ID: 1759294887 Enrollment ID: O20031106000088 |
Entity Name | Surgical Associates Of Neenah, S.c. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285792341 PECOS PAC ID: 4486625258 Enrollment ID: O20040804001098 |
Mailing Address | Practice Location Address |
---|---|
Jeremy R Luedtke, MD 400 Legacy Plz W, La Porte, IN 46350-5296 Ph: (219) 379-3166 | Jeremy R Luedtke, MD 400 Legacy Plz W, La Porte, IN 46350-5296 Ph: (219) 379-3166 |
Christopher Adam Conn, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 600 Legacy Plz W, La Porte, IN 46350 Phone: 219-379-3166 Fax: 219-324-9730 | |
Brian G Moore, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 900 I St Fl 2, La Porte, IN 46350 Phone: 219-575-6060 Fax: 219-575-6004 | |
Jaron Lee Pettis, Surgery Medicare: Medicare Enrolled Practice Location: 1331 State St Ste 340, La Porte, IN 46350 Phone: 219-379-3166 | |
Dr. Dorene Kay Zerfas, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 901 Lincolnway, Suite 304, La Porte, IN 46350 Phone: 219-362-8523 Fax: 219-324-9396 | |
Dr. Steven William Chmil, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 901 Lincolnway, Suite 304, La Porte, IN 46350 Phone: 219-362-8523 Fax: 219-324-9396 | |
Dr. David Samuel Mendelowitz, MD Surgery Medicare: Medicare Enrolled Practice Location: 1300 State Street, Suite 2c, La Porte, IN 46350 Phone: 219-325-0152 Fax: 219-325-8621 | |
James T Cornwell, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 900 I St, La Porte, IN 46350 Phone: 219-324-1700 Fax: 219-324-1602 |