Individual provider Active NPI

Andreja B Lakic, CAA

  • Anesthesiologist Assistant
  • Madison, WI
National Provider Identifier
1396286399
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
526 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-3427
Phone
(608) 263-8100
NPI assigned
Mar 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 67.000292 OH
Anesthesiologist Assistant 367H00000X 526 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-3427

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170524000777 GA Practitioner - Anesthesiology Assistant 2365719218 Reassigns benefits to 3 organizations
I20230418002366 WI Practitioner - Anesthesiology Assistant 2365719218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
526WIMDAudiologist
67.000292OHMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Nov 1, 2021 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Apr 17, 2023 Accepting new patients
Ams Southeast LLC Anesthesiologist Assistant CurrentSince May 11, 2019 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Apr 2, 2017 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Apr 17, 2023 Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1396286399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537923427",
            "telephone_number": "608-263-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKIC",
        "first_name": "ANDREJA",
        "middle_name": "B",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000292",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "WI",
            "license": "526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.