Lifestar Emergency Medical Services, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6001359 Issued in WI

Legal business name

LIFESTAR EMERGENCY MEDICAL SERVICES, LLC

Practice address

279 S 17TH Ave Stop 8
West Bend, WI 53095-3001

Phone

(262) 335-9950

Fax

(262) 335-9720

NPI assigned

Nov 18, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Michael L Krueger, EMTP

Title

President

Phone

(262) 335-9950

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1366424707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 113",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530950113",
            "telephone_number": "262-335-9950",
            "fax_number": "262-335-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 S 17TH AVE STOP 8",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953001",
            "telephone_number": "262-335-9950",
            "fax_number": "262-335-9720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 N Water St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "WI",
            "postal_code": "539251539",
            "country_code": "US",
            "telephone_number": "920-350-0190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W7185 State Road 49",
            "address_purpose": "LOCATION",
            "city": "Waupun",
            "state": "WI",
            "postal_code": "539639026",
            "country_code": "US",
            "telephone_number": "920-345-1050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Weil Dr",
            "address_purpose": "LOCATION",
            "city": "Slinger",
            "state": "WI",
            "postal_code": "530869375",
            "country_code": "US",
            "telephone_number": "262-644-8975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Beech St",
            "address_purpose": "LOCATION",
            "city": "Grafton",
            "state": "WI",
            "postal_code": "530241854",
            "country_code": "US",
            "telephone_number": "262-777-0784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4345 Hwy 33 W",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530959107",
            "country_code": "US",
            "telephone_number": "262-429-1189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "511 Main St",
            "address_purpose": "LOCATION",
            "city": "Friendship",
            "state": "WI",
            "postal_code": "539348015",
            "country_code": "US",
            "telephone_number": "608-339-8977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFESTAR EMERGENCY MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-335-9950",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMTP"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41353100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41475100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Lempke
• Tammy Leonard, OT
• John F Lesko, M.D.
• Mary E Lewis, M.D.
• Katherine Sue Liaromatis, CSAC-130 166
• Margaret Rae Lijewski, D.C.
• Pamela J Linden, RN
• Harry M Link, RPH
• Jody Link, PTA
• Ashley Linsmeier, APNP

• Land Ambulance in West Bend, WI
• Providers in West Bend, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.