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FROEDTERT MANITOWOC MEDICAL GROUP, LLC
NPI 1437829975
Clinic/Center - Multi-Specialty in Manitowoc, WI

Active since September 16, 2021CLIA 52D0958116 · Waiver
2300 WESTERN AVE, MANITOWOC, WI 54220(920) 320-2436 Get Directions Write a Review

NPPES record last updated: July 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 7, 2025, Dec 6, 2023, Jul 19, 2023 and 4 more (7 updates tracked since 2021).

About Froedtert Manitowoc Medical Group, Llc NPPES

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

FROEDTERT MANITOWOC MEDICAL GROUP, LLC (NPI 1437829975), doing business as Froedtert Northeast Medical Group, is a healthcare organization registered as a multi-specialty in Manitowoc, Wisconsin and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through August 30, 2027, maintains 9 additional practice locations, and lists Michael W Degere, Secretary/treasurer, as its authorized official.

NPPES Registry Identity

NPI1437829975
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameFROEDTERT MANITOWOC MEDICAL GROUP, LLC
Location Address2300 WESTERN AVEManitowoc, WI 54220-3712
Mailing Address400 Woodland Prime Ste 103, N74 W12501 Leatherwood CourtMenomonee Falls, WI 53051-4490
Phone(920) 320-2436
Organization SubpartNo
Authorized OfficialMichael W DegereSecretary/treasurer · (920) 320-2095
Enumeration DateSeptember 16, 2021
Last NPPES UpdateJuly 7, 20257 updates tracked since enumeration
NPPES CertifiedJuly 7, 2025
✔ NPI 1437829975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedInternal MedicineTaxonomy 207R00000X
2300 WESTERN AVE, Manitowoc, WI 54220
Open in Google Maps ↗

Other Names 1

Doing Business AsFroedtert Northeast Medical Group

Secondary Practice Locations 9

Location 11414 N Taylor DrSheboygan, WI 53081-1988 · Phone (920) 320-2011
Location 22631 Eastern AvePlymouth, WI 53073-4270 · Phone (920) 320-2436
Location 3800 Lakefront WayTwo Rivers, WI 54241-3301 · Phone (920) 320-2011
Location 44303 Michigan AveManitowoc, WI 54220-3066 · Phone (920) 320-2011
Location 51650 S 41st StManitowoc, WI 54220-7316 · Phone (920) 320-2011
Location 61635 S 21st StManitowoc, WI 54220-6380 · Phone (920) 320-2011
Location 7339 Reed AveManitowoc, WI 54220-2020 · Phone (920) 320-2011
Location 81081 E Johnson StFond Du Lac, WI 54935-8919 · Phone (920) 367-6700 · Fax (262) 799-4657
Location 93736 S Taylor DrSheboygan, WI 53081-8432 · Phone (920) 476-6300 · Fax (920) 328-1403

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Network Health.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0958116

Froedtert Manitowoc Medical Group, LLC · Manitowoc, WI
Active · expires Aug 30, 2027
CLIA Number52D0958116
Laboratory TypeCommunity Clinic
Certificate Effective DateAugust 31, 2025
Certificate Expiration DateAugust 30, 2027
Laboratory DirectorDr. Mary J. Gentine
Laboratory Phone(920) 320-2243
Laboratory LocationFroedtert Manitowoc Medical Group, LLC2300 Western Avenue, Manitowoc, WI 54220
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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.

TONEE' RENE HACKER COTA
Occupational Therapy Assistant
2300 WESTERN AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-3112
JENNIFER L MARSHALL M.D.
Anesthesiology
2300 WESTERN AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-2564
VLADIMIR N SWERCHOWSKY MD
Internal Medicine (Cardiovascular Disease)
2300 WESTERN AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-3000
JESSICA L CHOUINARD PT
Physical Therapist
2300 WESTERN AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-8667
LOLA BRIDGET DEFEVER MS, CF-SLP
Speech-Language Pathologist
2300 WESTERN AVE
MANITOWOC, WI 54220
Manitowoc County (262) 804-7554
DARLENE WIEGAND RPH-PHARMACIST
Pharmacist
2300 WESTERN AVE
MANITOWOC, WI 54220
Manitowoc County (920) 320-2274
DR. POOJA BHARAT PATEL MD, MBS
Internal Medicine
2300 WESTERN AVE
MANITOWOC, WI 54220
Manitowoc County (262) 505-9131
HAILEY ELIZABETH BOYER SLP
Speech-Language Pathologist
2300 WESTERN AVE
MANITOWOC, WI 54220
Manitowoc County (920) 684-2011

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 Froedtert Manitowoc Medical Group, LLC's NPI number?

The NPI number for Froedtert Manitowoc Medical Group, LLC is 1437829975. It was assigned to this organization in the NPPES registry on September 16, 2021. The provider is doing business as Froedtert Northeast Medical Group.

Where is Froedtert Manitowoc Medical Group, LLC located?

Froedtert Manitowoc Medical Group, LLC is located at 2300 Western Ave, Manitowoc, WI 54220. The listed phone number is (920) 320-2436.

What is Froedtert Manitowoc Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Froedtert Manitowoc Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0958116) is associated with this NPI, valid through August 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Froedtert Manitowoc Medical Group, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, HealthPartners and Network Health list Froedtert Manitowoc Medical Group, LLC 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.

When was this NPI record last updated?

The NPPES record for Froedtert Manitowoc Medical Group, LLC was last updated on July 7, 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.