Leah Peterson, - Medicare Nurse Practitioner in Appleton, WI

Leah Peterson, is a medicare enrolled "Nurse Practitioner - Family" in Appleton, Wisconsin. Her current practice location is 3925 N Gateway Dr, Appleton, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 830-6877.

Leah 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 Peterson,
3925 N Gateway Dr,
Appleton, WI 54913-7863
(920) 830-6877
Not Available



Provider's Profile

Full NameLeah Peterson
GenderFemale
SpecialityNurse Practitioner - Family
Location3925 N Gateway Dr, Appleton, 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: 11/04/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 4789053299
  • Enrollment ID: I20221205003102

Medical Identifiers

Medical identifiers for Leah 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 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

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Entity NameThedacare Medical Center - Shawano, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548260839
PECOS PAC ID: 5890605836
Enrollment ID: O20031117000117

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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. Leah 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 Peterson,
617 E Brewster St,
Appleton, WI 54911-3719

Ph: () -
Leah Peterson,
3925 N Gateway Dr,
Appleton, WI 54913-7863

Ph: (920) 830-6877

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Nurse Practitioner Nurses in Appleton, WI

Ann M Hefter, AGACNP-BC, MSN, BSN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1818 N Meade St, Appleton, WI 54911
Phone: 920-731-8900    
Dessia J Laxton-reinke, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1818 N Meade St, Appleton, WI 54911
Phone: 920-731-8900    Fax: 920-738-5369
Katie Geiser, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 5045 W Grande Market Dr, Appleton, WI 54913
Phone: 920-886-9380    
Lisa Valiquette, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2500 E Capitol Dr, Appleton, WI 54911
Phone: 920-738-4600    Fax: 920-738-4792
Kimberly A Romenesko, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1818 N Meade St, Appleton, WI 54911
Phone: 920-735-7645    Fax: 920-735-7618
Steven R Hamel, APN FP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 3925 N Gateway Dr, Appleton, WI 54913
Phone: 920-830-6877    
Ms. Zoua Yang, APNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1818 N Meade St, Appleton, WI 54911
Phone: 920-731-4101    

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