St Gianna Molla Clinic, Inc - Medicare Primary Care in De Pere, WI

St Gianna Molla Clinic, Inc is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in De Pere, Wisconsin. The current practice location for St Gianna Molla Clinic, Inc is 1716 Lawrence Dr Ste 100, De Pere, Wisconsin. For appointments, you can reach them via phone at (920) 605-3115. The mailing address for St Gianna Molla Clinic, Inc is 1716 Lawrence Dr Ste 100, De Pere, Wisconsin and phone number is (920) 605-3115.

St Gianna Molla Clinic, Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1104426477. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (920) 605-3115.

Contact Information

St Gianna Molla Clinic, Inc
1716 Lawrence Dr Ste 100
De Pere
WI 54115-9108
(920) 605-3115
(920) 486-6826

Map and Direction


Primary Care Clinic Profile

Full NameSt Gianna Molla Clinic, Inc
SpecialityClinic/Center
Location1716 Lawrence Dr Ste 100, De Pere, Wisconsin
Authorized Official Name and PositionRobin Goldsmith (PRESIDENT/CHIEF MEDICAL OFFICER)
Authorized Official Contact9207161451
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
St Gianna Molla Clinic, Inc
1716 Lawrence Dr Ste 100
De Pere
WI 54115-9108

Ph: (920) 605-3115
St Gianna Molla Clinic, Inc
1716 Lawrence Dr Ste 100
De Pere
WI 54115-9108

Ph: (920) 605-3115

NPI Details:

NPI Number1104426477
Provider Enumeration Date10/27/2020
Last Update Date04/05/2023

Medicare PECOS Information:

Medicare PECOS PAC ID2163836339
Medicare Enrollment IDO20210129000133

Medical Identifiers

Medical identifiers for St Gianna Molla Clinic, Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104426477NPI-NPPES
100163645MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
207V00000XObstetrics & Gynecology (* (Not Available))Secondary
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. St Gianna Molla Clinic, Inc acts as a billing entity for following providers:
Provider NameThomas E Reinardy
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1194710509
PECOS PAC ID: 6406852920
Enrollment ID: I20080326000164
Provider NameMichelle A Lopez
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1780618728
PECOS PAC ID: 6608911839
Enrollment ID: I20100226000586
Provider NameLloyd C Cassidy
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1457795569
PECOS PAC ID: 7810213451
Enrollment ID: I20190418001271
Provider NameMadeleine Neri Guevara
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1225254451
PECOS PAC ID: 5496818890
Enrollment ID: I20190607000084
Provider NameBrianna Klotz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851954267
PECOS PAC ID: 6204163942
Enrollment ID: I20190803000096
Provider NameJames Joyce
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1326017724
PECOS PAC ID: 4789713686
Enrollment ID: I20230315000914
Provider NameRobert James Rucinski
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1831174580
PECOS PAC ID: 1850749417
Enrollment ID: I20231121001883

Reviews and Comments


Clinic/Center in De Pere, WI

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Phone: 718-530-8357    Fax: 920-328-9050
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Phone: 920-338-1111    Fax: 920-339-6795
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Medicare: Not Enrolled in Medicare
Practice Location: 555 Redbird Cir, De Pere, WI 54115
Phone: 920-338-6870    

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.