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DR. LAUREN RENEE LODHOLZ O.D.
NPI 1043449978
Optometrist in Sturgeon Bay, WI

Active since July 13, 2009PECOS EnrolledAccepts Medicare Assignment
73.78/100
CMS Quality Rating
165 N 3RD AVE, STURGEON BAY, WI 54235(920) 743-2020(920) 743-9601 Get Directions Write a Review

NPPES record last updated: March 10, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Lauren Renee Lodholz O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LAUREN RENEE LODHOLZ O.D. (NPI 1043449978) is an individual optometrist in Sturgeon Bay, Wisconsin, licensed in Wisconsin (4060-35) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS and is a graduate of Southern College Of Optometry (2009).

NPPES Registry Identity

NPI1043449978
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. LAUREN RENEE LODHOLZCredential: O.D.
Location Address165 N 3RD AVESturgeon Bay, WI 54235-2415
Mailing Address165 N 3rd AveSturgeon Bay, WI 54235-2415 · (920) 743-2020 · Fax (920) 743-9601
Phone(920) 743-2020
Fax(920) 743-9601
Sole ProprietorNo
Medical School CMSSouthern College Of OptometryGraduated 2009
Enumeration DateJuly 13, 2009
Last NPPES UpdateMarch 10, 2026
NPPES CertifiedMarch 10, 2026
✔ NPI 1043449978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in WI · 4060-35
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
165 N 3RD AVE, Sturgeon Bay, WI 54235
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Other Identifiers 1

Medicaid7100108590KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Lauren Renee Lodholz O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416003199
PECOS Enrollment IDI20250905001516
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lauren Lodholz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Door County Eye Associates, Inc
Same address
Optometrist
165 N 3RD AVE
Sturgeon Bay, WI 54235
  • Reassigned Medicare billing, Wisconsin enrollment
  • 4 clinicians in this Medicare group
NPI 1356391718 (920) 743-2020

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
350 services265 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
164 services163 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
141 services129 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
112 services108 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
96 services89 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
80 services78 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54235 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

73.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.77
Improvement Activities40
Cost39.57

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
20%195 patients1/55-star benchmark: 100%
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…
71%21 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
86%2,463 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
52%470 patients2/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
4%27 patients1/55-star benchmark: 96%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%796 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
99%2,890 patients5/55-star benchmark: 99%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 224 patients
Patients tobacco: 98% · 224 patients
40%106 patients2/55-star benchmark: 98%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
97%33 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
62%2,890 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
22%2,890 patients2/55-star benchmark: 59%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SAI OAK OD
Optometrist
165 N 3RD AVE
STURGEON BAY, WI 54235
Door County (920) 743-2020
ANNIKA PAULSEN OD
Optometrist
165 N 3RD AVE
STURGEON BAY, WI 54235
Door County (920) 743-2020
DR. JOHN ERIC PAULSEN O.D.
Optometrist
165 N 3RD AVE
STURGEON BAY, WI 54235
Door County (920) 743-2020
DOOR COUNTY EYE ASSOCIATES, INC
Optometrist
165 N 3RD AVE
STURGEON BAY, WI 54235
Door County (920) 743-2020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lauren Lodholz's NPI number?

The NPI number for Lauren Lodholz is 1043449978. It was assigned to this individual provider in the NPPES registry on July 13, 2009.

Where is Lauren Lodholz located?

Lauren Lodholz practices at 165 N 3rd Ave, Sturgeon Bay, WI 54235. The listed phone number is (920) 743-2020.

What is Lauren Lodholz's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Lauren Lodholz enrolled in Medicare?

Yes. Lauren Lodholz is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Lauren Lodholz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lauren Lodholz reassigns Medicare benefits to Door County Eye Associates, Inc (Sturgeon Bay, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lauren Lodholz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lauren Lodholz accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and CareSource (Common Ground Healthcare) and 4 other insurers list Lauren Lodholz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lauren Lodholz was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.