Active NPI
Roger A Lalich, DO
- Obstetrics & Gynecology Physician
- Waukesha, WI
National Provider Identifier
1326038811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 21566
- Practice address
- 721 American Ave
Suite 304
Waukesha, WI 53188-5071 - Phone
- (262) 549-2229
- Fax
- (262) 549-1657
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 21566 | WI | Primary |
Addresses
Primary practice location
721 American Ave
Suite 304
Waukesha, WI 53188-5071
Mailing address
721 American Ave
Suite 304
Waukesha, WI 53188-5071
Phone (262) 549-2229
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30010700 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21566 | WI | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345161600000",
"number": "1326038811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 AMERICAN AVE",
"address_2": "SUITE 304",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885071",
"telephone_number": "262-549-2229",
"fax_number": "262-549-1657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 AMERICAN AVE",
"address_2": "SUITE 304",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885071",
"telephone_number": "262-549-2229",
"fax_number": "262-549-1657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALICH",
"first_name": "ROGER",
"middle_name": "A",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2012-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WI",
"license": "21566",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30010700",
"state": "WI"
}
],
"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 Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.