Doctor profile · Federal record

Dr. Lacey Jandrin, PA-C

Physician Assistant · Occupational Therapist · Physician Assistant · Green Bay, WI

  • NPI 1104183516
  • Accepts Medicare
  • 10 yrs in practice
  • Female
  • Group practice
  • No sanctions

Practice & contact

Operates at 5 locations .

NPPES Updated May 11, 2026
Primary practice
1970 S Ridge RD
Green Bay, WI 543044125
(920) 430-4888
fax (920) 430-4889
Additional location
1160 Kepler Dr
Green Bay, WI 543118321
(920) 288-5555
fax (920) 288-5550
Additional location
2820 Roosevelt RD
Marinette, WI 541433834
(715) 735-5225
fax (715) 735-5388
Show 2 more locations
Additional location
3415 Custer St Ste D
Manitowoc, WI 542204328
(920) 652-9310
fax (920) 652-9316
Additional location
820 Arbutus Ave
Oconto, WI 541532004
(920) 835-1100
fax (920) 835-1099
Mailing address
Po Box 22487
Green Bay, WI 543052487

Credentials & registration

NPPES · NUCC
NPI registered
April 2012 — 14 yrs on file
Profile last updated
January 30, 2023
Year of graduation
2016 — 10 yrs since
Specialty taxonomy
363A00000X — NUCC code
State licenses (3)
Wisconsin #3761-23 · Wisconsin #4712 · Wisconsin #1135070

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1104183516. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
266
Distinct HCPCS
8
Medicare allowed
$16,079
HCPCS Description Services Patients Avg allowed
99213 Established patient office or other outpatient visit, 20-29 minutes 56 44 $74
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 48 33 $1
99204 New patient office or other outpatient visit, 45-59 minutes 33 33 $135
20550 Injection into tendon or ligament 32 26 $45
99214 Established patient office or other outpatient visit, 30-39 minutes 32 29 $104
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 24 18 $6
99203 New patient office or other outpatient visit, 30-44 minutes 21 21 $91
20600 Aspiration and/or injection of fluid from small joint 20 15 $32

In context: peer comparison

Among 67 peers in Green Bay Physician Assistant, average services per provider: 85. This provider delivers 3.1× the peer median.

Frequently asked questions

Auto-generated from federal data
What is Dr. Lacey Jandrin's medical specialty?
Dr. Lacey Jandrin practices Physician Assistant in Green Bay, WI.
Where does Dr. Lacey Jandrin practice?
Dr. Lacey Jandrin practices at 1970 S Ridge RD, Green Bay, WI 543044125. Office phone: 9204304888.
What is Dr. Lacey Jandrin's NPI?
Dr. Lacey Jandrin's National Provider Identifier (NPI) is 1104183516, issued by NPPES.
Does Dr. Lacey Jandrin accept Medicare assignment?
Yes. Dr. Lacey Jandrin accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Lacey Jandrin commonly perform?
Top Medicare-reported procedures in 2023: Established patient office or other outpatient visit (HCPCS 99213); Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS J3301); New patient office or other outpatient visit (HCPCS 99204). Source: CMS Medicare Physician & Other Practitioners file.