Individual provider Active NPI

Ryan Joseph Lau, MD

  • Otolaryngology Physician
  • Waukesha, WI
National Provider Identifier
1205455102
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
85818-20 Issued in WI
Practice address
1111 Delafield St Ste 102
Waukesha, WI 53188-3402
Phone
(262) 547-1614
Fax
(262) 547-0192
NPI assigned
Apr 10, 2020
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 85818-20 WI Primary

Addresses

Primary practice location

1111 Delafield St Ste 102
Waukesha, WI 53188-3402

Mailing address

1111 Delafield St Ste 102
Waukesha, WI 53188-3402
Phone (262) 547-1614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250909000725 WI Practitioner - Otolaryngology 5890118376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Medical College of Wisconsin, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moreland Ear Nose and Throat Group LTDGroup PAC ID 4284605494, 13 clinicians

Practice addresses (Care Compare)

1111 Delafield St
Suite 102
Waukesha, WI 53188-3402
Phone (262) 547-1614

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85818-20WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moreland Ear Nose & Throat Group LTD CurrentSince Sep 1, 2025 Accepting new patients

Locations

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

13900 W National Ave
Ste 100
New Berlin, WI 53151
Phone (262) 928-4500

1185 Corporate Center Dr
Ste 205
Oconomowoc, WI 53066
Phone (262) 560-0760

1111 Delafield St
Ste 102
Waukesha, WI 53188
Phone (262) 547-1614

Organizations & group practices 1

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 1

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1205455102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST STE 102",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883402",
            "telephone_number": "262-547-1614",
            "fax_number": "262-547-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST STE 102",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883402",
            "telephone_number": "262-547-1614",
            "fax_number": "262-547-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "85818-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.