ST. NICHOLAS HOSPITAL SHEBOYGAN SURGERY CENTER
NPI 1568992337
Clinic/Center - Multi-Specialty in Sheboygan, WI

NPI Status: Active since June 14, 2017

Contact Information

3141 SAEMANN AVE
SHEBOYGAN, WI
ZIP 53081
Phone: (920) 783-5000

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  • Organization
  • Clinic/Center
  • Multi-Specialty
  • CLIA Number: 52D1082577
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 05-02-2027

About ST. NICHOLAS HOSPITAL SHEBOYGAN SURGERY CENTER

This page provides the complete NPI Profile along with additional information for St. Nicholas Hospital Sheboygan Surgery Center, a provider established in Sheboygan, Wisconsin operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1568992337 assigned on June 2017. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as St. Nicholas Hospital Sheboygan Surgery Center. The authorized official of this NPI record is Mr. Justin Selle (Ceo)

NPI
1568992337
Provider Legal Name
ST. NICHOLAS HOSPITAL-SISTERS OF THE THIRD ORDER OF ST. FRANCIS
Other Organization Name
ST. NICHOLAS HOSPITAL SHEBOYGAN SURGERY CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3141 SAEMANN AVE SHEBOYGAN, WI 53081
Location Phone
(920) 783-5000
Mailing Address
3141 SAEMANN AVE SHEBOYGAN, WI 53081
Mailing Phone
(920) 783-5000
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-14-2017
Last Update Date
07-21-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. JUSTIN SELLE

Authorized Official Title
CEO
Authorized Official Phone
(920) 459-4798

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
52D1082577
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
May 03, 2025
Certificate Expiration Date
May 02, 2027
Laboratory Director
DR. ROBERT T. CUTLAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to St. Nicholas Hospital Sheboygan Surgery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1568992337, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
8
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
9
Unchanged
Pos 7
2
Doubled → 4
Pos 8
3
Unchanged
Pos 9
3
Doubled → 6
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 9 → 18 → 9 2 → 4 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 2 + 8 + 1 + 8 + 9 + 4 + 3 + 6 + 24 = 73

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 73 is 80. The difference is the calculated check digit.

80 - 73 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1568992337.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinic/Center (Ambulatory Surgical)
3141 SAEMANN AVE
SHEBOYGAN, WI 53081

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568992337, enumerated as an "organization" on June 14, 2017.

The provider is located at 3141 SAEMANN AVE SHEBOYGAN, WI 53081 and the phone number is (920) 783-5000.

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.