STACY LAMAE VAN SAMBEEK PA
NPI 1366824179
Physician Assistant in Neenah, WI

Q: What is Stacy Van Sambeek's NPI number?

The NPI number for Stacy Van Sambeek is 1366824179. It was assigned to this individual provider in the NPPES registry on June 29, 2015. The provider is also known as Stacy Lamae Backen.

Q: What is Stacy Van Sambeek'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 Stacy Van Sambeek was last updated on May 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 June 29, 2015PECOS EnrolledAccepts Medicare Assignment

130 2ND ST, NEENAH, WI 54956(920) 725-0077(920) 725-6535 Get Directions Write a Review

NPPES record last updated: May 20, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 20, 2021, Mar 14, 2017 (2 updates tracked since 2017).

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About Stacy Lamae Van Sambeek Pa NPPES

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

STACY LAMAE VAN SAMBEEK PA (NPI 1366824179) is an individual physician assistant in Neenah, Wisconsin, licensed in Wisconsin (3579) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and maintains a secondary practice location in Appleton.

NPPES Registry Identity

NPI1366824179

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSTACY LAMAE VAN SAMBEEKCredential: PA

Location Address130 2ND STNeenah, WI 54956-2883

Mailing AddressPo Box 8003Appleton, WI 54912-8003 · (920) 996-3200 · Fax (920) 725-6535

Phone(920) 725-0077

Fax(920) 725-6535

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJune 29, 2015

Last NPPES UpdateMay 20, 20212 updates tracked since enumeration

NPPES CertifiedMay 20, 2021

✔ NPI 1366824179 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 · 3579

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.

130 2ND ST, Neenah, WI 54956

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Other Names 1

Former Name (1)Stacy Lamae Backen

Secondary Practice Location 1

Location 1820 E Grant StAppleton, WI 54911-3483 · Phone (920) 831-5050 · Fax (920) 725-6535

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), 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

Stacy Lamae Van Sambeek Pa 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 ID2365756574

PECOS Enrollment IDI20150731016709

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.

19 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520045

Location130 2nd StNeenah, WI 54956 · Winnebago County

Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520160

Location1818 N Meade StAppleton, WI 54911 · Outagamie County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54956 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.

JENNIFER MARIE KETTERHAGEN PHARMD

Pharmacist

130 2ND ST
NEENAH, WI 54956

Winnebago County (920) 454-5080

JAMES P MANDERLE MD

Nurse Anesthetist, Certified Registered

130 2ND ST, STE. A107
NEENAH, WI 54956

Winnebago County (920) 729-3332

ALLISON A HOELZEL OT

Occupational Therapist

130 2ND ST
NEENAH, WI 54956

Winnebago County (920) 729-2616

ELIZABETH BONSON PT

Physical Therapist

130 2ND ST
NEENAH, WI 54956

Winnebago County (920) 729-2155

SARAH M MARTIN

Physical Therapist

130 2ND ST
NEENAH, WI 54956

Winnebago County (920) 454-2973

JUSTIN EISBERNER

Nurse Anesthetist, Certified Registered

130 2ND ST
NEENAH, WI 54956

Winnebago County (920) 729-3100

DR. ERIK VERHAGE MD

Pediatrics (Neonatal-Perinatal Medicine)

130 2ND ST
NEENAH, WI 54956

Winnebago County (920) 969-7900

ALYSSA ANN ROTZENBERG

Physical Therapist

130 2ND ST
NEENAH, WI 54956

Winnebago County (920) 729-3100

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 Stacy Van Sambeek's NPI number?

The NPI number for Stacy Van Sambeek is 1366824179. It was assigned to this individual provider in the NPPES registry on June 29, 2015. The provider is also known as Stacy Lamae Backen.

Where is Stacy Van Sambeek located?

Stacy Van Sambeek practices at 130 2nd St, Neenah, WI 54956. The listed phone number is (920) 725-0077.

What is Stacy Van Sambeek's specialty?

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

Is Stacy Van Sambeek enrolled in Medicare?

Yes. Stacy Van Sambeek 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 Stacy Van Sambeek accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare) and Network Health list Stacy Van Sambeek 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 Stacy Van Sambeek affiliated with any hospitals?

According to CMS data, Stacy Van Sambeek is affiliated with Thedacare Regional Med Ctr - Neenah and Thedacare Regional Medical Center - Appleton Inc.

When was this NPI record last updated?

The NPPES record for Stacy Van Sambeek was last updated on May 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.