Individual provider Active NPI

Lara Speranza Lazarre Ries, M.D.

  • Neurology Physician
  • Oostburg, WI
National Provider Identifier
1124393228
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
82353-20 Issued in WI
Practice address
220 S Business Park Dr Ste A6
Oostburg, WI 53070-1586
Phone
(920) 207-5499
Fax
(920) 306-8504
NPI assigned
Mar 21, 2012
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD-43783 IA
Neurology Physician 2084N0400X 82353-20 WI Primary
Neurology Physician 2084N0400X MD-22041 HI

Addresses

Primary practice location

220 S Business Park Dr Ste A6
Oostburg, WI 53070-1586

Mailing address

220 S Business Park Dr Ste A6
Oostburg, WI 53070-1586
Phone (920) 802-2100

Other identifiers 1

IdentifierTypeStateIssuer
100246626MedicaidWI

Other names 1

  • Lara S Lazarre Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.happyneuroclinic.org Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230831001486 WI Practitioner - Neurology 4880828235
I20260601001555 NC Practitioner - Neurology 4880828235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Indiana University School of Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5221 Paramount Pkwy
Suite 220
Morrisville, NC 27560-4704

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-43783IAMDNeurology Physician
82353-20WIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Hospital Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1124393228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S BUSINESS PARK DR STE A6",
            "city": "OOSTBURG",
            "state": "WI",
            "postal_code": "530701586",
            "telephone_number": "920-802-2100",
            "fax_number": "920-306-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S BUSINESS PARK DR STE A6",
            "city": "OOSTBURG",
            "state": "WI",
            "postal_code": "530701586",
            "telephone_number": "920-207-5499",
            "fax_number": "920-306-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIES",
        "first_name": "LARA",
        "middle_name": "SPERANZA LAZARRE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IA",
            "license": "MD-43783",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "82353-20",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "HI",
            "license": "MD-22041",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100246626",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.happyneuroclinic.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "website with fax number (920) 306-8504",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "220 S Business Park Dr Ste A6",
            "city": "Oostburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530701586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "LAZARRE",
            "middle_name": "S",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oostburg, WI

Sources for this page

Verify at the official NPI Registry.