PREVEA SHEBOYGAN HEALTH CENTER
NPI 1275799413
Internal Medicine in Sheboygan, WI
NPI Status: Active since August 06, 2008
Contact Information
1621 N TAYLOR DR
SHEBOYGAN, WI
ZIP 53081
Phone: (920) 458-4419
- Organization
- Internal Medicine
- Accepts Insurance
- CLIA Number: 52D1095434
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-08-2027
About PREVEA SHEBOYGAN HEALTH CENTER
This page provides the complete NPI Profile along with additional information for Prevea Sheboygan Health Center, an internist established in Sheboygan, Wisconsin operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1275799413 assigned on August 2008. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Prevea Sheboygan Health Center operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Prevea Sheboygan Health Center. The authorized official of this NPI record is Mr. Justin Selle (President & Ceo)
- NPI
- 1275799413
- Provider Legal Name
- ST. NICHOLAS HOSPITAL-SISTERS OF THE THIRD ORDER OF ST FRANCIS
- Other Organization Name
- PREVEA SHEBOYGAN HEALTH CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1621 N TAYLOR DR SHEBOYGAN, WI 53081
- Location Phone
- (920) 458-4419
- Mailing Address
- PO BOX 19070 GREEN BAY, WI 54307
- Mailing Phone
- (920) 496-4700
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 08-06-2008
- Last Update Date
- 07-07-2023
- Code Navigator
An internist like Prevea Sheboygan Health Center is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | (WI) |
| 2 | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | (WI) |
| 3 | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 4 | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 5 | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | (WI) |
| 6 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 7 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 8 | 207YX0905X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 9 | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | |
| 10 | 208800000X | Allopathic & Osteopathic Physicians | Urology | |
| 11 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | |
| 12 | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
| 13 | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
| 14 | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 9200 (+ Incentives) - HMO
- Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Essential 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Chorus Bronze Complete - EPO
- Chorus Bronze HDHP - EPO
- Chorus Catastrophic - EPO
- Chorus Core Bronze - EPO
- Chorus Core Gold - EPO
- Chorus Core Silver - EPO
- Chorus Elite Gold - EPO
- Chorus Gold - EPO
- Chorus Silver - EPO
- Chorus Silver Select - EPO
- Prevea360 Bronze HSA - HMO
- Prevea360 Bronze Share - HMO
- Prevea360 Catastrophic - HMO
- Prevea360 Expanded Bronze Standard - HMO
- Prevea360 Gold HSA - HMO
- Prevea360 Gold Share - HMO
- Prevea360 Gold Standard - HMO
- Prevea360 Silver $0 Copay PCP Visits - HMO
- Prevea360 Silver Share - HMO
- Prevea360 Silver Standard - HMO
- Engage by Medica Bronze HSA - EPO
- Engage by Medica Bronze Share - EPO
- Engage by Medica Expanded Bronze Standard - EPO
- Engage by Medica Gold $0 Copay PCP Visits - EPO
- Engage by Medica Gold Share - EPO
- Engage by Medica Gold Standard - EPO
- Engage by Medica Silver $0 Copay PCP Visits - EPO
- Engage by Medica Silver Share - EPO
- Engage by Medica Silver Standard - EPO
- Essentia Choice Care with Medica Bronze HSA - EPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Premier $1,500 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,100 HDHP - HMO
- Premier $5,000 - 40% - HMO
- Premier $6,200 HDHP - HMO
- Premier $7,500 - HMO
- Premier $9,200 - HMO
- Premier Protection - HMO
- Select $1,500 - 25% - EPO
- Select $3,500 - 30% - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 21327400 | MEDICAID (05) | WI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D1095434
- Facility Type
- Physician Office
- Certificate Effective Date
- February 09, 2025
- Certificate Expiration Date
- February 08, 2027
- Laboratory Director
- DR. SARAH J. MIROCHA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Prevea Sheboygan Health Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 7 | 5 | 7 | 9 | 9 | 4 | 1 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 14 | 5 | 14 | 9 | 18 | 4 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 4 + 5 + 1 + 4 + 9 + 1 + 8 + 4 + 2 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1275799413 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 17 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1699761403 | KATHARINE A DONOHUE FNP-C Individual | Nurse Practitioner (Family) | 1621 N TAYLOR DR SUITE 300 SHEBOYGAN, WI 53081 (920) 496-4700 |
| 1518948967 | MRS. CORINNE JEPSEN-HOBBS APNP Individual | Nurse Practitioner (Family) | 1621 N TAYLOR DR SHEBOYGAN, WI 53081 (920) 458-7433 |
| 1295791002 | MATTHEW ONCOLOGY ASSOCIATES Organization | Internal Medicine (Hematology & Oncology) | 1621 N TAYLOR DR SUITE 100 SHEBOYGAN, WI 53081 (920) 458-7433 |
| 1669529608 | STEVEN MARK BETTAG MD Individual | Internal Medicine (Medical Oncology) | 1621 N TAYLOR DR SHEBOYGAN, WI 53081 (920) 458-7433 |
| 1790999472 | DR. DONNA J HABECK M.D. Individual | Preventive Medicine (Occupational Medicine) | 1621 N TAYLOR DR # 300 SHEBOYGAN, WI 53081 (920) 496-4700 |
| 1326220823 | HOSPICE AND PALLIATIVE CARE CONSULTANTS Organization | Internal Medicine (Hospice and Palliative Medicine) | 1621 N TAYLOR DR SHEBOYGAN, WI 53081 (920) 458-7433 |
| 1265604839 | DAWN C. BAARENDSE NP Individual | Nurse Practitioner (Obstetrics & Gynecology) | 1621 N TAYLOR DR SHEBOYGAN, WI 53081 (920) 458-4419 |
| 1083927412 | MARY LOU ROETHEL MSN,NP-C,APNP Individual | Nurse Practitioner (Family) | 1621 N TAYLOR DR SUITE 300 SHEBOYGAN, WI 53081 (920) 496-4700 |
| 1114215886 | LAURA ALSTEEN APNP Individual | Nurse Practitioner | 1621 N TAYLOR DR SUITE 300 SHEBOYGAN, WI 53081 (920) 496-4700 |
| 1487637856 | MR. H MARSHALL MATTHEWS MD Individual | Internal Medicine (Hematology & Oncology) | 1621 N TAYLOR DR SUITE 100 SHEBOYGAN, WI 53081 (920) 458-7433 |
| 1942628623 | STACY MILLER NP-C Individual | Nurse Practitioner (Adult Health) | 1621 N TAYLOR DR SUITE 100 SHEBOYGAN, WI 53081 (920) 459-8300 |
| 1477620201 | JENNIFER A ENGLISH APNP Individual | Nurse Practitioner | 1621 N TAYLOR DR SUITE 300 SHEBOYGAN, WI 53081 (920) 496-4700 |
| 1972804854 | DAVID BEIMBORN PT Individual | Physical Therapist | 1621 N TAYLOR DR SUITE 300 SHEBOYGAN, WI 53081 (920) 496-4700 |
| 1528232576 | MARLA Z WOLFERT M.D. Individual | Internal Medicine (Gastroenterology) | 1621 N TAYLOR DR SHEBOYGAN, WI 53081 (920) 496-4700 |
| 1285789297 | SHEBOYGAN CANCER & BLOOD SPECIALISTS, SC Organization | Internal Medicine (Medical Oncology) | 1621 N TAYLOR DR SHEBOYGAN, WI 53081 (920) 458-7433 |
| 1275660383 | SHEBOYGAN LUNG SPECIALISTS, SC Organization | Internal Medicine (Critical Care Medicine) | 1621 N TAYLOR DR SHEBOYGAN, WI 53081 (920) 458-5864 |
| 1801381900 | NIKITA JAIN MD Individual | Internal Medicine (Hematology & Oncology) | 1621 N TAYLOR DR SHEBOYGAN, WI 53081 (920) 452-1650 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275799413, enumerated in the NPI registry as an "organization" on August 06, 2008
The provider is located at 1621 N Taylor Dr Sheboygan, Wi 53081 and the phone number is (920) 458-4419
This medical organization specializes in Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Chorus. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 52D1095434 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on August 06, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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