Laeekha A Ali, MD
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Beaver Dam, WI
NPI 1245200427 · NPPES record last updated May 11, 2023
Key facts
- NPI
- 1245200427
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 28738 (WI)
- Practice address
- 707 S University Ave
Beaver Dam, WI 53916-3027 - Phone
- (920) 887-7181
- Fax
- (920) 887-6833
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060223000717 | WI | Practitioner - Pathology | 4688680911 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Black River Health Inc | Current |
Accepting new patients | |
| Marshfield Clinic Inc | Current |
Accepting new patients | |
| Beaver Dam Community Hospitals Inc | Current |
Accepting new patients | |
| Black River Health Inc | Current |
Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Divine Savior Healthcare, Inc. | Current |
Accepting new patients | |
| Divine Savior Healthcare, Inc. | Current |
Accepting new patients | |
| Beaver Dam Community Hospitals Inc | Current |
Accepting new patients | |
| Quest Diagnostics LLC Il | Past |
Accepting new patients | |
| Ameripath Milwaukee SC | Past | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090
707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006
711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302
3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200
1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598
Interoperability endpoints
- laeekha.ali@marshfieldclinichealthsystem.cernerdirect.com
- him@marshfieldclinichealthsystem.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 28738 | WI | Yes |
Addresses
Primary practice location
707 S University Ave
Beaver Dam, WI 53916-3027
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32510400 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@marshfieldclinichealthsystem.cernerdirect.com | Other |
Other providers in Beaver Dam, WI
- Agnesian Healthcare Inc
- Michelle Agnew
- Ahamed A Ahamed
- Rula Al-Baghdadi
- Kim Michelle Albridge
- Bradley A Allen
- Robert A Allen
- Dale R Alt
- Adam Altenburg
- Samantha Alvarado
All providers in Beaver Dam, WI · Anatomic Pathology & Clinical Pathology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.