GRANT MICHAEL ROETHEL
NPI 1174408306
Nurse Practitioner in Sheboygan, WI
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 St Nicholas Hospital, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
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.
Medicare Billing Reassignment
Medicare enrollment records show Grant Roethel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Manitowoc, WI 54220
- Reassigned Medicare billing, Wisconsin enrollment
- 350 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Nicholas Hospital
Acute Care Hospitals · Sheboygan, WIHoly Family Memorial
Acute Care Hospitals · Manitowoc, WIPhysician 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.
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.
SHEBOYGAN, WI 53081
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.
Which organization bills Medicare for Grant Roethel's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Grant Roethel reassigns Medicare benefits to Froedtert Manitowoc Medical Group, LLC (Manitowoc, 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 Grant Roethel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Grant Roethel accept?
Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, HealthPartners 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 St Nicholas Hospital and 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 13 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.
# Grant Michael Roethel · NPI 1174408306
Nurse Practitioner physician in Sheboygan, Wisconsin. Individual provider, active in the CMS NPPES registry since August 7, 2025.
## Identity
- **NPI:** 1174408306 (Entity type: Individual)
- **Enumerated:** August 7, 2025
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 17248-33 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 1414 N TAYLOR DR, Sheboygan, WI 53081-1988
- **Phone:** (920) 476-6300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Froedtert Manitowoc Medical Group, LLC (NPI 1437829975, Manitowoc, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** September 19, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1174408306) · Data from the CMS NPPES public registry.