DR. LLOYD CHARLES IV CASSIDY (MD) – Family Medicine Physician, NPI 1457795569

DR. LLOYD CHARLES IV CASSIDY (MD) is a healthcare provider. based in Shawano, Wisconsin. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 036144493 (IL). The NPI Number for DR. LLOYD CHARLES IV CASSIDY (MD) is 1457795569

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. LLOYD CHARLES IV CASSIDY (MD)
NPI
1457795569
Phone
(715) 526-2111
Address
100 COUNTY ROAD
Enumeration Date
18 April 2013
Last Update Date
27 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9206053115
Graduation Year
2013 (13 years ago)
PAC ID
7810213451
Group Practice PAC ID
2163836339
Professional Enrollment ID
I20190418001271
Address ID
WI541159108DE1716XDRXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:13State licenses:3Digital endpointsOther names

1,309 EMERGENCY MEDICINE in WI

Provider Addresses for DR. LLOYD CHARLES IV CASSIDY (MD)

  • 100 COUNTY ROAD

    SHAWANO, WI 541667072

    Phone: (715) 526-2111

    Fax: (715) 526-7308

    Type: Location

  • 124 SIEGLER ST

    GREEN BAY, WI 543032636

    Phone: (920) 605-3115

    Fax: (920) 486-6826

    Type: Location

  • 1500 S Main St

    Family Medicine Residency Program

    Fort Worth, TX 761044917

    Phone: (817) 702-1204

    Type: Location

  • 2875 W. 19th Street

    Chicago, IL 60623

    Phone: (773) 484-1000

    Type: Location

  • 100 County Road

    Shawano, WI 541667072

    Phone: (715) 526-2111

    Fax: (715) 526-7308

    Type: Location

  • 353 N DESPLAINES ST APT 607

    CHICAGO, IL 606611245

    Phone: (847) 502-2979

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-04-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150226000568IEmergency MedicineTXTBD
I20180403000469IFamily PracticeILTBD
I20190418001271IEmergency MedicineWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2814$0
99239Hospital discharge day management, more than 30 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 54166)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163836339View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YWI
O B S T E T R I C S/ G Y N E C O L O G YMI
Family Practice, Obstetrics/GynecologyWI
Nurse PractitionerWI

Reviews

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Frequently asked questions

What identifier follows DR. LLOYD CHARLES IV CASSIDY (MD) across health systems?
The NPI 1457795569 uniquely identifies DR. LLOYD CHARLES IV CASSIDY (MD) in U.S. healthcare data.
Quick check: is DR. LLOYD CHARLES IV CASSIDY (MD) active?
Public NPPES data shows DR. LLOYD CHARLES IV CASSIDY (MD) with an active NPI status right now.
What services align with DR. LLOYD CHARLES IV CASSIDY (MD)'s listing?
DR. LLOYD CHARLES IV CASSIDY (MD)'s public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to DR. LLOYD CHARLES IV CASSIDY (MD)?
The directory associates DR. LLOYD CHARLES IV CASSIDY (MD) with Shawano, Wisconsin. Check all listed addresses for suites or satellite offices.
Why is information missing for DR. LLOYD CHARLES IV CASSIDY (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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