LOGAN J MACIEJEWSKI PA-C
NPI 1174297808
Physician Assistant in Green Bay, WI

Q: What is Logan Maciejewski's NPI number?

The NPI number for Logan Maciejewski is 1174297808. It was assigned to this individual provider in the NPPES registry on August 5, 2021.

Q: What is Logan Maciejewski'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 Logan Maciejewski was last updated on February 1, 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 August 05, 2021PECOS EnrolledAccepts Medicare Assignment

2845 GREENBRIER RD, GREEN BAY, WI 54311(920) 288-8000 Get Directions Write a Review

NPPES record last updated: February 1, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 1, 2023, Jan 5, 2022, Aug 5, 2021 (3 updates tracked since 2021).

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About Logan J Maciejewski Pa-c NPPES

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

LOGAN J MACIEJEWSKI PA-C (NPI 1174297808) is an individual physician assistant in Green Bay, Wisconsin, licensed in Wisconsin (5598) and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1174297808

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameLOGAN J MACIEJEWSKICredential: PA-C

Location Address2845 GREENBRIER RDGreen Bay, WI 54311-6519

Mailing AddressPo Box 28900Green Bay, WI 54324-0900 · (920) 490-9046 · Fax (920) 405-5388

Phone(920) 288-8000

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateAugust 5, 2021

Last NPPES UpdateFebruary 1, 20233 updates tracked since enumeration

NPPES CertifiedFebruary 1, 2023

✔ NPI 1174297808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 5598

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.

2845 GREENBRIER RD, Green Bay, WI 54311

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Logan J Maciejewski 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 ID4183013642

PECOS Enrollment IDI20211123000561

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

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.

84 services82 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

Hshs St Clare Memorial Hospital

Critical Access Hospitals · Oconto Falls, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521310

Location855 S Main StOconto Falls, WI 54154 · Oconto County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54311 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.

AMRITHA CHANDRAHASA KARKERA M.D.

Internal Medicine (Hematology & Oncology)