NPIMap

Organization Active NPI

Neurotech, LLC

  • Physiological Laboratory
  • Waukesha, WI
National Provider Identifier
1225056252
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
NEUROTECH, LLC
Practice address
626 W Moreland Blvd
Waukesha, WI 53188-2433
Phone
(262) 754-0898
Fax
(262) 754-0897
NPI assigned
Jul 17, 2006
Last updated
Apr 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Authorized official

Name
Mr. Lance Morgan
Title
Chief Operating Officer
Phone
(262) 754-0898

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EEG TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 2472E0500X
Sleep Disorder Diagnostic Clinic/Center 261QS1200X WI
Physiological Laboratory 293D00000X Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

626 W Moreland Blvd
Waukesha, WI 53188-2433

Mailing address

626 W Moreland Blvd
Waukesha, WI 53188-2433
Phone (262) 754-0898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL, IN, WA, OH5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20070223000463 WI Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6305948225 Practice locations: Waukesha, WI
O20111221000445 IL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6305948225 1 other NPI on this enrollment
Practice locations: Schaumburg, IL
O20130515000495 IN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6305948225 1 other NPI on this enrollment
Practice locations: Indianapolis, IN
O20140318000090 WA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6305948225 1 other NPI on this enrollment
Practice locations: Spokane Valley, WA
O20150818004566 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6305948225 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Chester, OH

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1355 Remington Rd
Ste W
Schaumburg, IL 60173
Phone (262) 875-6602

941 E 86th St
Ste 107
Indianapolis, IN 46240
Phone (262) 875-6611

1101 Glendale Blvd
Ste 101-B
Valparaiso, IN 46383
Phone (219) 462-1040

41800 Hayes Rd
Ste 101
Clinton Township, MI 48038
Phone (262) 754-0898

8080 Beckett Center Dr
Ste 325
West Chester, OH 45069
Phone (513) 860-0801

8080 Beckett Center Dr
Ste 325327
West Chester, OH 45069
Phone (262) 875-6616

6627 S 191st Pl
Ste F110
Kent, WA 98032

15285 Watertown Plank Rd
Ste 2
Elm Grove, WI 53122
Phone (262) 754-0898

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1225056252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433",
            "telephone_number": "262-754-0898",
            "fax_number": "262-754-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433",
            "telephone_number": "262-754-0898",
            "fax_number": "262-754-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "262-754-0898",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2472E0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Other, EEG",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.