Wisconsin Opt Out List
This table is sortable by Specialty and Name. In order to sort the table, you will need to actually select the table titles.
Revised March 31, 2012
| Specialty | Name | Effective Dates | National Provider Identifier |
|---|---|---|---|
| 01 | Roth, DO, Delford M. | 03/29/2010 - 03/28/2012 | 1225123458 |
| 01 | Schwartz, MD, Norman | 04/01/2007 - 03/31/2013 | 1851401418 |
| 03 | Kadile, MD, Eleazar M. | 01/01/1999 - 12/31/2012 | 1083812887 |
| 07 | Engel, MD, Charles J. | 07/01/1998 - 06/30/2012 | 1649484205 |
| 08 | Brown, DO, Carol M. | 02/29/2012 - 02/28/2014 | 1457497927 |
| 08 | Fernando, MD, Manellema N. | 07/01/2007 - 06/30/2013 | 1750597886 |
| 08 | Green, MD, R. Kevin | 10/01/2011 - 10/09/2013 | 1801901897 |
| 08 | Reyes-Clauson, DO, Michele | 10/01/2000 - 09/30/2012 | 1538109566 |
| 08 | Sabatino, DO, Jeffrey T. | 03/26/2012 - 03/25/2014 | 1336227834 |
| 08 | Simon, MD, Bozena | 06/09/2011 - 06/08/2013 | 1437249125 |
| 08 | Toth, MD, Glenn A. | 10/01/2001 - 09/30/2013 | 1851300933 |
| 08 | Uebelacker, MD, Carol | 01/01/2012 - 12/31/2013 | 1891767240 |
| 08 | Usher, MD, J. David | 10/01/2011 - 09/30/2013 | 1336110170 |
| 11 | Engel, MD, Charles J. | 07/01/1998 - 06/30/2012 | 1649484205 |
| 11 | Goldstone, MD, Michael S. | 07/01/1998 - 06/30/2012 | 1851505416 |
| 11 | Kumar, MD, Kalpama M. | 07/01/2004 - 06/30/2012 | 1235188681 |
| 11/93 | Meress, MD, Steven G. | 04/01/2003 - 03/31/2013 | 1144375825 |
| 19 | Abu Jamra, DDS, Nicolas | 09/24-2008 - 09/23/2012 | 1720123201 |
| 19 | Albrecht II, DDS, James A. | 11/16/2010 - 11/15/2012 | 1871569475 |
| 19 | Barnett, DDS, Nancy A. | 01/01/2012 - 12/31/2013 | 1912093386 |
| 19 | Barr, DDS, David P. | 02/01/2010 -01/31/2014 | 1033131834 |
| 19 | Beaupre, DDS, Dan L. | 09/03/2008 - 09/02/2012 | 1669530002 |
| 19 | Burke, DDS, Jeffrey J. | 07/01/2007 - 06/30/2013 | 1760684930 |
| 19 | Carroll, DDS, Christopher S. | 12/01/2010 - 11/30/2012 | 1043317647 |
| 19 | Challenger, DDS, Martin | 07/01/2010 - 06/30/2012 | 1700802691 |
| 19 | Cruthers, DDS, Aaron E. | 02/03/2010 - 02/02/2014 | 1710016209 |
| 19 | Dreger, DDS, Ross A. | 02/01/2010 - 01/31/2014 | 1043239130 |
| 19 | Eaton, DDS, Derek J. | 07/08/2010 - 07/07/2012 | 1477649432 |
| 19 | Elcano, DDS, Paul M. | 02/03/2010 - 02/02/2014 | 1386779791 |
| 19 | Emery, DDS, Allison L. | 02/03/2010 - 02/02/2014 | 1528193935 |
| 19 | English, DDS, Ellyn | 07/01/2010 - 06/30/2012 | 1003835711 |
| 19 | Entin, DDS, Barry M. | 02/02/2010 - 02/01/2014 | 1629103049 |
| 19 | Erbes, DDS, William T. | 04/15/2009 - 04/14/2013 | 1720082175 |
| 19 | Eslami, DDS, Ahmad | 04/01/2005 - 03/31/2013 | 1801907886 |
| 19 | Fohey, DDS, Mark G. | 07/14/2004 - 07/13/2012 | 1780787374 |
| 19 | Franzen, DDS, Barry R. | 02/07/2012 - 02/06/2014 | 1225077910 |
| 19 | French, DDS, Christopher J. | 04/01/2011 - 03/31/2013 | 1427029073 |
| 19 | Friedeck, DDS, James R. | 06/30/2004 - 06/29/2012 | 1659496578 |
| 19 | Gholson, DDS, Dan J. | 01/01/2009 - 12/31/2012 | 1609814540 |
| 19 | Hall, DDS, Dan J. | 01/01/2009 - 12/31/2012 | 1609814540 |
| 19 | Hansen, DDS, Chris J. | 08/01/2004 - 07/31/2012 | 1386752970 |
| 19 | Heim, DDS, Lindsey | 07/01/2010 - 06/30/2012 | 114448973 |
| 19 | Hein, DDS, Steven R. | 07/01/2009 - 06/30/2013 | 1942373550 |
| 19 | Hendrickson, DDS, Curtis J. | 04/14/2009 - 04/13/2013 | 1487660387 |
| 19 | Hendrickson, DDS, Michael J. | 04/14/2009 - 04/13/2013 | 1881600161 |
| 19 | Henry, DDS, Thomas | 06/30/2004 - 06/29/2012 | 1811012743 |
| 19 | Hickson, DDS, Christopher J. | 06/23/2009 - 06/22/2013 | 1306901459 |
| 19 | Holsen, DDS, Jeffrey J. | 01/13/2005 - 01/12/2013 | 1710999354 |
| 19 | Honl, DDS, Thomas J. | 06/01/2006 - 05/31/2012 | 1568441038 |
| 19 | Houting, DDS, Thomas V. | 04/01/2009 - 03/31/2013 | 1831215748 |
| 19 | Hussong, DDS, Dean R | 07/17/2008 - 07/16/2012 | 1790901395 |
| 19 | Insolera, DDS, Paul A. | 07/01/2009 - 06/30/2013 | 1710903752 |
| 19 | Johnston, DDS, Stephen A. | 07/07/2008 - 07/06/2012 | 1497884852 |
| 19 | Julian, DDS, Christine | 07/01/2010 - 06/30/2012 | 1730108424 |
| 19 | Kabele, DDS, Andrew J. | 04/15/2009 - 04/14/2013 | 1932362092 |
| 19 | Kenfield, DDS, Mark R. | 02/02/2010 - 02/01/2014 | 1549309121 |
| 19 | Knoell, DDS, Lyndsay N. | 06/16/2009 - 06/15/2013 | 1942387542 |
| 19 | Knoell, DDS, Wendy | 06/22/2009 - 06/21/2013 | 1902983505 |
| 19 | Knoll, DDS, Jennifer Lee | 07/07/2008 - 07/06/2012 | 1255498234 |
| 19 | Korthals, DDS, Gordon D. | 04/01/2005 - 03/31/2013 | 1235271792 |
| 19 | Kurth, DDS, Steven L. | 07/14/2004 - 07/13/2012 | 1780787150 |
| 19 | Ladesic, DDS, Kevin T. | 04/01/2011 - 03/31/2013 | 1669537924 |
| 19 | Larson, DDS, Christi A. | 07/28/2010 - 07/27/2012 | 1942513957 |
| 19 | Lasnoski, DDS, Joseph W. | 05/25/2004 - 05/24/2012 | 1346331741 |
| 19 | Lasslo, DDSErin L. | 09/23/2008 - 09/22/2012 | 1245411099 |
| 19 | Lee, DDS, Rollyn P. | 06/15/2006 - 06/14/2012 | 1649284134 |
| 19 | Lese DDS, Ronald J. | 10/01/2008 - 09/30/2012 | 1760493050 |
| 19 | Letter, DDS, Mark A. | 12/09/2004 - 12/08/2012 | 1528153616 |
| 19 | Lin, DDS, Edward Y. | 10/01/2009 - 09/30/2013 | 1962737336 |
| 19 | Linstroth, DDS, Thomas J. | 02/03/2010 - 02/02/2014 | 1396870770 |
| 19 | Long, DDS, Ryan | 07/01/2010 - 06/30/2012 | 1740459783 |
| 19 | Lornson, DDS, Thomas E. | 01/01/2005 - 12/31/2010 03/09/2011 - 03/08/2013 | 1396894127 |
| 19 | MacMenanin, DDS, Luke | 01/09/2007 - 01/08/2013 | 1679645733 |
| 19 | Malin DDS, Leo J. | 07/07/2008 - 07/06/2012 | 1619043510 |
| 19 | Mason, DDS, David C. | 04/15/2009 - 04/14/2013 | 1144236027 |
| 19 | Mueller, DDS, Charles R. | 04/20/2009 - 04/19/2013 | 1295746568 |
| 19 | Munro, DDS, Scott D. | 02/14/2010 - 02/13/2014 | 1326173709 |
| 19 | Nelson, DDS, Matthew A. | 07/20/2009 - 07/19/2013 | 1801057492 |
| 19 | Newton, DDS, Earl L. | 02/02/2010 - 02/01/2014 | 1023143435 |
| 19 | O'Brien, DDS, Meghan K. | 01/14/2010 - 01/13/2014 | 1194823112 |
| 19 | O'Brien, DDS, Timothy J. | 01/21/2010 - 01/20/2014 | 1659488849 |
| 19 | Orchekowski, DDS, Michael O. | 09/03/2008 - 09/02/2012 | 1194883439 |
| 19 | Palmer, DDS, Richard E. | 02/08/2010 - 02/07/2014 | 1770618175 |
| 19 | Paukner, DDS, Keith R. | 08/09/2006 - 08/08/2012 | 1437168606 |
| 19 | Ragonese, DDS, Anthony L. | 07/01/2009 - 06/30/2013 | 1649350398 |
| 19 | Reese, DDS, Michael J. | 08/01/2009 - 07/31/2013 | 1558477760 |
| 19 | Rodenburg, DDS, Steven | 01/09/2007 - 01/08/2013 | 1457423519 |
| 19 | Scherrer, DDS, Thomas W. | 02/02/2010 - 02/01/2014 | 1275668667 |
| 19 | Schroeder, DDS, Kyle | 04/01/2011 - 03/31/2013 | 1679543714 |
| 19 | Selmo, DDS, Don L. | 03/25/2010 - 03/24/2014 | 1831275312 |
| 19 | Shook, DDS, Randal E. | 06/30/2004 - 06/29/2012 | 1982729794 |
| 19 | Simes, DDS, Derf A. | 02/09/2010 - 02/08/2014 | 1891820270 |
| 19 | Stellpflug, DDS, John N. | 07/23/2009 - 07/22/2013 | 1699801688 |
| 19 | Stromberg, DDS, Robert G. | 07/01/2004 - 06/30/2012 | 1598762866 |
| 19 | Thiel DDS, Jason A. | 09/24/2008 - 09/23/2012 | 1407867773 |
| 19 | Travis, DDS, Curtis F. | 06/30/2004 - 06/29/2012 | 1386769222 |
| 19 | Twohig, DDS, William J. | 09/01/2009 - 08/31/2013 | 1275536161 |
| 19 | Tyberg, DDS, Paul D. | 01/16/2006 - 01/15/2014 | 1699862094 |
| 19 | VanGorden, DDS, Schuyler | 06/30/2004 - 06/29/2012 | 1306961206 |
| 19 | Veerman, DDS, Lori | 07/01/2010 - 06/30/2012 | 1720004724 |
| 19 | Vravick, DDS, John A. | 10/21/2008 - 10/20/2012 | 1467527788 |
| 19 | Wackwitz, DDS, Brian J. | 08/11/2010 - 08/10/2012 | 1548489420 |
| 19 | Wagner, DDS, Richard M. | 01/01/2011 - 12/31/2013 | 1770700957 |
| 19 | Waldau, DDS, Brian J. | 01/01/2012 - 12/31/2013 | 1578624730 |
| 19 | Wanserski, DDS, David J. | 02/02/2004 - 02/01/2014 | 1205916822 |
| 19 | Wirtz, DDS, Alanna | 07/01/2010 - 06/30/2012 | 1154340867 |
| 19 | Witkowski, DDS, Daniel P. | 08/23/2004 - 08/22/2012 | 1538256409 |
| 19 | Yarnell, DDS, Kenneth | 07/01/2010 - 06/30/2012 | 1841216728 |
| 19 | Youssef, DDS, Riad E. | 04/01/2007 - 03/31/2013 | 1689746737 |
| 26 | Carducci, DO, Geralyn A. | 04/28/1998 - 04/27/2012 | 1790869717 |
| 26 | Gorelick, MD, Jeffrey B. | 06/21/2010 - 06/20/2012 | 1328143947 |
| 26 | Frank, MD, Richard A. | 04/01/2010 - 03/31/2012 | 1174564728 |
| 26 | Hicks III, MD, John H. | 06/25/2009 - 06/24/2013 | 1750404885 |
| 26 | Junig, MD, Jeffrey T. | 10/01/2010 - 09/30/2012 | 1366409823 |
| 26 | Kalogjera, MD, Ikar J. | 07/01/2011 - 06/30/2013 | 1083696736 |
| 26 | Lyles, MD, William B. | 01/01/2008 - 12/31/2013 | 1386799328 |
| 26 | McQueeney, MD, Robert T. | 11/15/2011 - 11/14/2013 | 1891820874 |
| 26 | Penn, M, Julia H. D | 02/01/2011 - 01/31/2013 | 1336269968 |
| 26 | Stonefeld., MD, Donald F. | 12/01/2011 - 11/30/2013 | 1144362880 |
| 26 | Taxman, MD, Jeffrey E. | 01/18/2005 - 01/17/2013 | 1114066610 |
| 26 | Zigun, MD, Jeffrey R. | 10/01/2009 - 09/30/2013 | 1033131768 |
| 40 | Stark, MD, Ron H. | 01/01/2009 - 12/31/2012 | 1780655928 |
| 50 | Muth, NP, Debra | 07/01/2007 - 06/30/2013 | 1619992732 |
| 50 | Schliecher, NP, Cherri A. | 09/26/2011 - 09/25/2013 | 1851363592 |
| 68 | Banks, PhD, Jean | 10/07/2010 - 10/06/2012 | 1497839096 |
| 68 | Burbach, PhD, Daniel J. | 10/01/2005 - 09/30/2013 | 1700960713 |
| 68 | DiFiancesco, PhD, Chiara | 04/01/2004 - 03/31/2012 | 1114049962 |
| 68 | Ferguson, PhD, Donald D. | 07/01/2009 - 06/30/2013 | 1073557716 |
| 68 | Garrison, PhD, Diane C. | 11/01/2010 - 10/31/2012 | 1427115716 |
| 68 | Harris, PhD, Earlene M. | 10/20/2010 - 10/19/2012 | 1538362728 |
| 68 | Harris, PhD, Jane C. | 02/17/2011 - 02/16/2013 | 1821132101 |
| 68 | Herzog, PhD, Jeanne | 02/16/2009 - 02/15/2013 | 1124173133 |
| 68 | Kramer, PhD, Kathleen M. | 04/06/2006 - 04/05/2012 | 1699809640 |
| 68 | Krings, PhD, Judith B. | 10/01/2004 - 09/30/2012 | 1962637868 |
| 68 | Modell, Phd, Craig A. | 08/01/2011 - 07/31/2013 | 1366552887 |
| 68 | Morningstar, PhD, Jim | 07/01/2000 - 06/30/2012 | 1669687406 |
| 68 | Osborn, PhD, Michael E. | 10/28/2010 - 10/27/2012 | 1982714408 |
| 68 | Soeldner, PhD, Stacey E. | 07/01/2006 - 06/30/2012 | 1942326053 |
| 68 | Stone, PhD, Linda A. | 01/01/2011 - 12/31/2013 | 1184774242 |
| 68 | Van Niel, PhD, Janice A. | 04/16/2010 - 04/15/2012 | 1497957724 |
| 80 | Anderson, LCSW, Amy B. | 01/01/2012 - 12/31/2013 | 1295766186 |
| 80 | Benavides, LCSW, Daniel L. | 02/28/2011 - 02/27/2013 | 1427103431 |
| 80 | Filipiak, LCSW, Michael J. | 04/01/2010 - 03/31/2012 | 1811050032 |
| 80 | Gause Bemis, LCSW, Christine | 10/07/2008 - 10/07/2012 | 1043386394 |
| 80 | Kaplan, LCSW, Jonathan | 01/01/2012 - 12/31/2013 | 1770618324 |
| 80 | Lewis, LCSW, Tracy S. | 07/01/2011 - 06/30/2013 | 1437219201 |
| 80 | Lipchik, LCSW, Eva | 01/18/2012 - 01/17/2014 | 1679638605 |
| 80 | Modell, LCSW, Patricia | 04/07/2011 - 04/06/2013 | 1962510255 |
| 80 | O'Connor, MSW, Janice S. | 05/01/2004 - 09/30/2012 | 1518000314 |
| 80 | Pagel, LCSW, Roger | 10/07/2008 - 10/06/2012 | 1609942903 |
| 80 | Pozorski, LCSW, Jennifer L. | 01/01/2012 - 12/31/2013 | 1811097900 |
| 80 | Randall, LCSW, Kevin | 10/10/2011 - 10/09/2013 | 1891985719 |
| 80 | Rotherham, MSW, Cheryl | 10/01/2007 - 09/30/2013 | 1578617502 |
| 80 | Scrivner, MSW, Eileen | 01/01/2004 - 12/31/2013 | 1376755496 |
| 80 | Soe, LCSW, Ann | 10/07/2008 - 10/06/2012 | 1053475616 |
| 80 | Waide, MSW, Michelle | 04/01/2004 - 03/31/2012 | 1467587956 |
| 85 | Krigbaum, DDS, David E. | 03/19/2012 - 03/18/2014 | 1750453049 |
| 85 | Santarelli, DDS, Gregory A. | 04/01/2010 - 03/31/2012 | 1578640488 |
| 85 | VanOven, DDS, Bryan. J. | 09/23/2010 - 09/22/2012 | 1720290174 |
| 93 | Adams, MD, Erik S. | 01/01/2012 - 12/31/2012 | 1881680510 |
| 93 | Eaton, MD, Thomas L. | 02/20/2009 - 02/19/2013 | 1265574719 |
| 93 | Masci, MD, Vance A. | 04/01/2010 - 03/31/2012 | 1538285028 |
| 93 | Whitcomb, MD, John E. | 06/03/2011 - 06/02/2013 | 1558325191 |
Page Last Updated: Monday, 07-May-2012 16:11:01 CDT
