LACEY L JANDRIN PA-C
NPI 1104183516
Physician Assistant in Green Bay, WI

Q: What is Lacey Jandrin's NPI number?

The NPI number for Lacey Jandrin is 1104183516. It was assigned to this individual provider in the NPPES registry on April 23, 2012. The provider is also known as Lacey L Bartz Pa-C.

Q: What is Lacey Jandrin's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Lacey Jandrin was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since April 23, 2012PECOS EnrolledAccepts Medicare Assignment

1970 S RIDGE RD, GREEN BAY, WI 54304(920) 430-4888(920) 430-4889 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Lacey L Jandrin Pa-c NPPES

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

LACEY L JANDRIN PA-C (NPI 1104183516) is an individual physician assistant in Green Bay, Wisconsin, licensed in Wisconsin (3761-23) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of University Of North Dakota School Of Medicine (2016).

NPPES Registry Identity

NPI1104183516

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameLACEY L JANDRINCredential: PA-C

Location Address1970 S RIDGE RDGreen Bay, WI 54304-4125

Mailing AddressPo Box 22487Green Bay, WI 54305-2487 · (920) 445-7210 · Fax (920) 445-7289

Phone(920) 430-4888

Fax(920) 430-4889

Sole ProprietorNo

Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 2016

Enumeration DateApril 23, 2012

Last NPPES UpdateJanuary 30, 2023

NPPES CertifiedJanuary 30, 2023

✔ NPI 1104183516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in WI · 3761-23✔ Licensed in WI · 1135070

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedOccupational TherapistTaxonomy 225X00000X · License 4712 (WI)

1970 S RIDGE RD, Green Bay, WI 54304

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Other Names 1

Former Name (1)Lacey L Bartz Pa-c

Secondary Practice Locations 4

Location 11160 Kepler DrGreen Bay, WI 54311-8321 · Phone (920) 288-5555 · Fax (920) 288-5550

Location 2820 Arbutus AveOconto, WI 54153-2004 · Phone (920) 835-1100 · Fax (920) 835-1099

Location 33415 Custer St Ste DManitowoc, WI 54220-4328 · Phone (920) 652-9310 · Fax (920) 652-9316

Location 42820 Roosevelt RdMarinette, WI 54143-3834 · Phone (715) 735-5225 · Fax (715) 735-5388

Other Identifiers 1

Other1135070National Commission On Certification Of Physician Assistants

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lacey L Jandrin Pa-c 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 ID8820380132

PECOS Enrollment IDI20160707000393

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.

Areas of Expertise CMS Part B claims 9

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

74 services27 patients

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.

68 services44 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

41 services41 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

36 services30 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

34 services21 patients

Aspiration and/or injection of fluid from small joint 20600

This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.

25 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54304 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

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.

Other Providers at the Same Location NPPES 20

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

KRISTA M SOLAREK PA-C

Physician Assistant