Lacey Jandrin, PA-C
NPI 1104183516 · Physician Assistant · Green Bay, WI
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lacey Jandrin, PA-C is a Physician Assistant provider in Green Bay, WI (NPI 1104183516).
Provider details
- NPI number
- 1104183516
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 4712 (WI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
14 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
5 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
218 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 68 | $72 |
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203 | 41 | $89 |
| Injection Into Tendon Or Ligament20550 | 36 | $43 |
| Aspiration And/Or Injection of Fluid From Small Joint20600 | 25 | $36 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 19 | $103 |
| X-Ray of Finger, Minimum of 2 Views73140 | 17 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 1 distinct drug on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Hydrocodone/Acetaminophenbrand: Hydrocodone-Acetaminophen | 23 | 23 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Additional practice locations (4)
- 1160 Kepler DrGreen Bay, WI 54311-8321Phone: (920) 288-5555Fax: (920) 288-5550
- 3415 Custer St Ste DManitowoc, WI 54220-4328Phone: (920) 652-9310Fax: (920) 652-9316
- 2820 Roosevelt RdMarinette, WI 54143-3834Phone: (715) 735-5225Fax: (715) 735-5388
- 820 Arbutus AveOconto, WI 54153-2004Phone: (920) 835-1100Fax: (920) 835-1099
Registry dates
- Enumerated
- 2012-04-23
- Last updated
- 2023-01-30
- Certified
- 2023-01-30
Frequently asked questions
- What is Lacey Jandrin's NPI number?
- Lacey Jandrin's National Provider Identifier (NPI) is 1104183516, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Lacey Jandrin's specialty?
- Lacey Jandrin is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Lacey Jandrin located?
- Lacey Jandrin's practice location on file with NPPES is 1970 S Ridge Rd, Green Bay, WI 54304-4125.
- What is Lacey Jandrin's phone number?
- The practice phone number listed in the NPPES registry for Lacey Jandrin is (920) 430-4888.
- Does Lacey Jandrin accept Medicare?
- Lacey Jandrin is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Lacey Jandrin's NPI active?
- Yes — Lacey Jandrin's NPI (1104183516) is active in the NPPES registry as of the last update on 2023-01-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.