Leah R Peterson, - Medicare Nurse Practitioner in Kimberly, WI

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Leah R Peterson, is a medicare enrolled "Nurse Practitioner - Family" in Kimberly, Wisconsin. Her current practice location is 520 W 3rd St, Kimberly, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 788-7680.

Leah R Peterson is licensed to practice in Wisconsin (license number 13279-33) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1710600317.

Contact Information

Leah R Peterson,
520 W 3rd St,
Kimberly, WI 54136-1300
(920) 788-7680
Not Available

Map and Direction




Provider's Profile

Full NameLeah R Peterson
GenderFemale
SpecialityNurse Practitioner - Family
Location520 W 3rd St, Kimberly, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1710600317
  • Provider Enumeration Date: 09/20/2022
  • Last Update Date: 10/09/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4789053299
  • Enrollment ID: I20221205003102

Medical Identifiers

Medical identifiers for Leah R Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710600317NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 13279-33 (Wisconsin)Primary

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. Leah R Peterson allows following entities to bill medicare on her behalf.
Entity NameThedacare, Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376656959
PECOS PAC ID: 1759294887
Enrollment ID: O20031106000088
Entity NameThedacare Medical Center - Shawano, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548260839
PECOS PAC ID: 5890605836
Enrollment ID: O20031117000117

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. Leah R Peterson 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 AddressPractice Location Address
Leah R Peterson,
617 E Brewster St,
Appleton, WI 54911-3719

Ph: () -		Leah R Peterson,
520 W 3rd St,
Kimberly, WI 54136-1300

Ph: (920) 788-7680

Reviews and Comments


Nurse Practitioner Nurses in Kimberly, WI

Katherine Lynn Erstad, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 520 W 3rd St, Kimberly, WI 54136
Phone: 920-788-7680    Fax: 920-788-7688

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.