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SARA DETTLAFF APNP
NPI 1750125514
Nurse Practitioner - Family in Green Bay, WI

Active since June 25, 2024PECOS EnrolledAccepts Medicare Assignment
744 S WEBSTER AVE FL 2, GREEN BAY, WI 54301(920) 433-3640(920) 433-3716 Get Directions Write a Review

NPPES record last updated: June 25, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Sara Dettlaff Apnp NPPES

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

SARA DETTLAFF APNP (NPI 1750125514) is an individual family provider in Green Bay, Wisconsin, licensed in Wisconsin (15486-33) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with Bellin Memorial Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1750125514
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSARA DETTLAFFCredential: APNP
Location Address744 S WEBSTER AVE FL 2Green Bay, WI 54301-3505
Mailing Address635 Castlestone CtOneida, WI 54155-9385 · (920) 676-5196
Phone(920) 433-3640
Fax(920) 433-3716
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJune 25, 2024
NPPES CertifiedJune 25, 2024
✔ NPI 1750125514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in WI · 15486-33
744 S WEBSTER AVE FL 2, Green Bay, WI 54301
Open in Google Maps ↗

Accepted Insurance

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

Sara Dettlaff Apnp 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 ID244771715
PECOS Enrollment IDI20240924003059
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Sara Dettlaff reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bellin Memorial Hospital Inc
Same address
Family Medicine
744 S WEBSTER AVE
Green Bay, WI 54301
  • Reassigned Medicare billing, Wisconsin enrollment
  • 875 clinicians in this Medicare group
NPI 1033172390 (920) 445-7272
Oconto Hospital & Medical Center Inc
24 mi
Rural Health
575 4TH ST
Kewaunee, WI 54216
  • Reassigned Medicare billing, Wisconsin enrollment
  • 573 clinicians in this Medicare group
NPI 1053279091 (920) 388-4640

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.

Bellin Memorial Hospital

Acute Care Hospitals · Green Bay, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520049
Location744 S Webster AveGreen Bay, WI 54305 · Brown County
Emergency services Birthing friendly

Door County Medical Center

Critical Access Hospitals · Sturgeon Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number521358
Location323 South 18th AvenueSturgeon Bay, WI 54235 · Door County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54301 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 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNE E VOGT F-NP
Nurse Practitioner (Family)
744 S WEBSTER AVE FL 2
GREEN BAY, WI 54301
Brown County (920) 433-3640
DR. RUDOLPH FRANCIS EVONICH III M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
744 S WEBSTER AVE FL 2
GREEN BAY, WI 54301
Brown County (920) 433-3640
DR. SUMIT NIKUNJ RINGWALA M.D.
Internal Medicine (Interventional Cardiology)
744 S WEBSTER AVE FL 2
GREEN BAY, WI 54301
Brown County (920) 433-3640
MRS. AMANDA L SHEFCHIK NP
Nurse Practitioner
744 S WEBSTER AVE FL 2
GREEN BAY, WI 54301
Brown County (920) 433-3640
CHRISTOPHER M WOLFRAM MD
Internal Medicine (Cardiovascular Disease)
744 S WEBSTER AVE FL 2
GREEN BAY, WI 54301
Brown County (920) 433-3640
ANGELA A KLEIN APNP
Nurse Practitioner (Family)
744 S WEBSTER AVE FL 2
GREEN BAY, WI 54301
Brown County (920) 433-3640
VIJAYA K MUNAGALA M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
744 S WEBSTER AVE FL 2
GREEN BAY, WI 54301
Brown County (920) 433-3640
DR. KRISTOFER MICHAEL DOSH M.D.
Internal Medicine (Cardiovascular Disease)
744 S WEBSTER AVE FL 2
GREEN BAY, WI 54301
Brown County (920) 433-3640

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 Sara Dettlaff's NPI number?

The NPI number for Sara Dettlaff is 1750125514. It was assigned to this individual provider in the NPPES registry on June 25, 2024.

Where is Sara Dettlaff located?

Sara Dettlaff practices at 744 S Webster Ave Fl 2, Green Bay, WI 54301. The listed phone number is (920) 433-3640.

What is Sara Dettlaff's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Sara Dettlaff enrolled in Medicare?

Yes. Sara Dettlaff 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 organizations bill Medicare for Sara Dettlaff's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sara Dettlaff reassigns Medicare benefits to 2 organizations: Bellin Memorial Hospital Inc (Green Bay, WI) and Oconto Hospital & Medical Center Inc (Kewaunee, WI). Each 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 Sara Dettlaff's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sara Dettlaff accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and HealthPartners list Sara Dettlaff 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 Sara Dettlaff affiliated with any hospitals?

According to CMS data, Sara Dettlaff is affiliated with Bellin Memorial Hospital and Door County Medical Center.

When was this NPI record last updated?

The NPPES record for Sara Dettlaff was last updated on June 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.