Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob E Lanzendorf, OT

Individual provider Occupational Therapist · NPI 1972157840

Jacob E Lanzendorf, OT is an Occupational Therapist in Private Practice in Green Bay, Wisconsin. Qualified in 2019, 7 years ago. Practices with Bellin Memorial Hospital Inc, a 681-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2019
What do these letters mean?
OT — Occupational Therapist
Helps people regain the skills needed for daily living and work.

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Practice location Address checks out

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone: (920) 430-4888
Fax: (920) 430-4889
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 744 S Webster Ave, Green Bay, WI 54301-3505 — (920) 433-7822
  • 3263 Eaton Rd, Green Bay, WI 54311-6830 — (920) 433-6700
  • 2820 Roosevelt Rd, Marinette, WI 54143-3834 — (715) 735-5225
  • 820 Arbutus Ave, Oconto, WI 54153-2004 — (920) 835-1100

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 6589-26 (WI)

Record details

NPI number1972157840
Entity typeIndividual (Type 1)
GenderMale
Credentials OT
Sole proprietorNo
NPI enumeratedJuly 30, 2019
Last updated in NPPESNovember 2, 2022
Certification dateNovember 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Bellin Memorial Hospital Inc — 681 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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