Alicja D Lisak, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

204136 Issued in NY

Practice address

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538

Phone

(262) 253-5400

NPI assigned

Aug 12, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Family Medicine

  NPD
• Ub Family Medicine, Inc

  • Family Medicine Physician
  • Williamsville, NY
  • NPI 1942294467
  NPD
• University Emergency Medical Services Inc.

  • Emergency Medicine Physician
  • Buffalo, NY
  • NPI 1972540482
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD (past)
• Elder Medical Services PC

  • Geriatric Medicine (Family Medicine) Physician
  • Cheektowaga, NY
  • NPI 1740388719
  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1295737823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W129N7055 NORTHFIELD DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510538",
            "telephone_number": "262-253-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W129N7055 NORTHFIELD DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510538",
            "telephone_number": "262-253-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISAK",
        "first_name": "ALICJA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "204136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295737823",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Ley
• Sara Elizabeth Libby Glapa, APNP
• Juan Miguel Limjoco, MD
• Lindengrove Communities LLC
• Scott Linton, M.D.
• Samantha Rose Llanas, MD
• Diane Marie Lobner, LPN
• Christine Lodl, RPH
• Jessica Taylor Lopez, SLP
• Kajua Betsy Lor, PHARMD

• Family Medicine Physician in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.