Great Lakes Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GREAT LAKES HOME HEALTH LLC

Practice address

2115 E Woodstock PL
Milwaukee, WI 53202-1342

Phone

(773) 825-3336

NPI assigned

May 28, 2021

Organization subpart

No

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

Authorized official

Name

Maxim Stesel

Title

Manager

Phone

(773) 819-2190

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Home health agency certification: CCN 527343

Legal name

GREAT LAKES HOME HEALTH LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 28, 2022

Last certification

Jul 21, 2022

Organization structure

LLCProprietary

Enrollment address

3217 Fiddlers Creek Dr
Waukesha, WI 53188-3946

Listed as

Great Lakes Home Health LLCCCN 527343 · All quality measures

Overall star rating

1.5 of 5

Ownership

-

Certified

Jul 28, 2022

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Sheboygan SNF Operations LLC

  • Skilled Nursing Facility
  • Sheboygan, WI
  • NPI 1669288650

  Eden Senior Care LLC

  CMS ownership

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Carrie Fitzsimmons, NP

  • Family Nurse Practitioner
  • Milwaukee, WI
  • NPI 1033523584

  Home health agency

  Care Compare affiliation
• Megan Kaczmarek, FNP-C

  • Family Nurse Practitioner
  • Waukesha, WI
  • NPI 1881464055

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1346816501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762914",
            "telephone_number": "177-381-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 E WOODSTOCK PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532021342",
            "telephone_number": "773-825-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "STESEL",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-819-2190"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony F Graziano, M.D.
• Milan Grbic, PT
• Valena Grbic, MD
• Matthew J Grbich, D.C.
• Great Lakes Behavior Analysis, Inc.
• Great Lakes Medical & Surgical Center
• Great Lakes Neurosurgical Associates LLC
• Greater Heights Counseling
• Greater Milwaukee Critical Care and Pulmonary Associates SC
• Greater Milwaukee Health Services, S.C.

• Home Health Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.