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GRANT MICHAEL ROETHEL
NPI 1174408306
Nurse Practitioner in Sheboygan, WI

Active since August 07, 2025PECOS EnrolledAccepts Medicare Assignment
1414 N TAYLOR DR, SHEBOYGAN, WI 53081(920) 476-6300 Get Directions Write a Review

NPPES record last updated: September 19, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 19, 2025, Aug 7, 2025 (2 updates tracked since 2025).

About Grant Michael Roethel NPPES

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

GRANT MICHAEL ROETHEL (NPI 1174408306) is an individual nurse practitioner in Sheboygan, Wisconsin, licensed in Wisconsin (17248-33) and active in the NPI registry since August 2025. He is enrolled in Medicare PECOS, is affiliated with Holy Family Memorial, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1174408306
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameGRANT MICHAEL ROETHEL
Location Address1414 N TAYLOR DRSheboygan, WI 53081-1988
Mailing Address1414 N Taylor DrSheboygan, WI 53081-1988 · (920) 946-1743
Phone(920) 476-6300
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 7, 2025
Last NPPES UpdateSeptember 19, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2025
✔ NPI 1174408306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WI · 17248-33
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1414 N TAYLOR DR, Sheboygan, WI 53081
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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, Network Health.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

Grant Michael Roethel 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 ID8628559721
PECOS Enrollment IDI20260226002477
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.

Hospital Affiliations CMS Care Compare

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

Holy Family Memorial

Acute Care Hospitals · Manitowoc, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520107
Location2300 Western AveManitowoc, WI 54221 · Manitowoc County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
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.

DR. LOUIE COULIS M.D.
Internal Medicine (Cardiovascular Disease)
1414 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 458-9800
KENNETH SIEBELS OTR/L
Occupational Therapist
1414 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 476-6300
MICHELLE VINE PT
Physical Therapist
1414 N TAYLOR DR, SUITE 105
SHEBOYGAN, WI 53081
Sheboygan County (920) 459-8475
EMILY JACOBSON DPT
Physical Therapist
1414 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 476-6300
KRISTOPHER T. KNOUS OD
Optometrist
1414 N TAYLOR DR, SUITE 105
SHEBOYGAN, WI 53081
Sheboygan County (920) 208-7700
CARMEN RUIZ APNP
Nurse Practitioner (Family)
1414 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 476-6300
DR. ALOYS LOUIS TAUSCHECK JR. M.D.,J.D.
Dermatology
1414 N TAYLOR DR, SUITE 144
SHEBOYGAN, WI 53081
Sheboygan County (920) 457-3376
SHEBOYGAN UROLOGY SPECIALISTS, S.C.
Urology
1414 N TAYLOR DR, SUITE 210
SHEBOYGAN, WI 53081
Sheboygan County (920) 457-4858

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 Grant Roethel's NPI number?

The NPI number for Grant Roethel is 1174408306. It was assigned to this individual provider in the NPPES registry on August 7, 2025.

Where is Grant Roethel located?

Grant Roethel practices at 1414 N Taylor Dr, Sheboygan, WI 53081. The listed phone number is (920) 476-6300.

What is Grant Roethel's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Grant Roethel enrolled in Medicare?

Yes. Grant Roethel 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.

What insurance does Grant Roethel accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Grant Roethel 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.

Is Grant Roethel affiliated with any hospitals?

According to CMS data, Grant Roethel is affiliated with Holy Family Memorial.

When was this NPI record last updated?

The NPPES record for Grant Roethel was last updated on September 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.