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
19Cruthers, 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