Dr Lisa Lynne Butenhoff Campbell, MD is a medicare enrolled "Dermatology" physician in De Pere, Wisconsin. She went to University Of Wisconsin School Of Medicine and graduated in 2002 and has 22 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Forefront Dermatology, Forefront Dermatology and her current practice location is
1400 Scheuring Rd, De Pere, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 964-0229.
Dr Lisa Lynne Butenhoff Campbell is licensed to practice in Wisconsin (license number 50518-20) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1124145040.
Physician's Profile
| Full Name | Dr Lisa Lynne Butenhoff Campbell |
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| Gender | Female |
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| Speciality | Dermatology |
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| Experience | 22 Years |
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| Location | 1400 Scheuring Rd, De Pere, Wisconsin |
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| Accepts Medicare Assignments | Yes. She 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:
- Dr Lisa Lynne Butenhoff Campbell attended and graduated from University Of Wisconsin School Of Medicine in 2002
NPI Data:
- NPI Number: 1124145040
- Provider Enumeration Date: 03/24/2007
- Last Update Date: 08/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 2567568322
- Enrollment ID: I20090325000700
Medical Identifiers
Medical identifiers for Dr Lisa Lynne Butenhoff Campbell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124145040 | NPI | - | NPPES |
| 171400016 | Other | WI | MEDICARE |
| 1124145040 | Medicaid | WI | |
| 382000020 | Other | WI | MEDICARE |
| 50518-020 | Other | WI | STATE LICENSE |
| P00720349 | Other | WI | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | MD430734 (Pennsylvania) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 4301105435 (Michigan) | Secondary |
| 207N00000X | Dermatology | 50518-20 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Forefront Dermatology | 3779471701 | 474 |
| Forefront Dermatology | 3779471701 | 474 |
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. Dr Lisa Lynne Butenhoff Campbell allows following entities to bill medicare on her behalf.
| Entity Name | Forefront Dermatology Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083768253
PECOS PAC ID: 3779471701
Enrollment ID: O20040310000252 |
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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. Dr Lisa Lynne Butenhoff Campbell 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 |
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Dr Lisa Lynne Butenhoff Campbell, MD
801 York St,
Manitowoc, WI 54220-4630
Ph: (920) 663-9008 | Dr Lisa Lynne Butenhoff Campbell, MD
1400 Scheuring Rd,
De Pere, WI 54115-1067
Ph: (920) 964-0229 |
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