Jackie Luthardt, MD
NPI 1679156202ActiveIndividual· Obstetrics & Gynecology· Fond Du Lac, WI
Obstetrics & Gynecology (MD) in Fond Du Lac, Wisconsin, trained at Michigan State University College of Human Medicine (class of 2021). Part D covered 19 prescriptions written in 2024, 100% of them generic.
Overview
| NPI | 1679156202 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | May 2, 2021 |
| Last updated in NPPES | Jul 31, 2025 |
| Certified by provider | Jul 31, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Obstetrics & Gynecology Primary | 207V00000X | 81595-20 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Obstetrics/Gynecology (WI) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 19 · 19 30-day fills |
|---|---|
| Patients | 16 |
| Total drug cost | $90.83 |
| Generic share | 100% of claims |
Education and affiliations
| Medical school | Michigan State University College of Human Medicine |
|---|---|
| Graduation year | 2021 |
| Medicare specialty | Obstetrics/Gynecology |
Medical group
- Agnesian Healthcare IncWaupun, WI · 388 clinicians
Hospital affiliation
- Ssm Health St Agnes Hospital-Fond Du LacFond Du Lac, WI
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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