Individual provider Active NPI

Laam Ko, D.O

  • Surgery Physician
  • Cudahy, WI
National Provider Identifier
1467624197
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
65212 Issued in WI
Practice address
5900 S Lake Dr
Cudahy, WI 53110-3171
Phone
(414) 744-6589
Fax
(414) 747-8848
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101017757 MI
Surgery Physician 208600000X 65212 WI Primary

Addresses

Primary practice location

5900 S Lake Dr
Cudahy, WI 53110-3171

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 1

IdentifierTypeStateIssuer
100056527MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address lko176915@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160513001789 WI Practitioner - General Surgery 6800024803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

950 N 12TH St
Milwaukee, WI 53233-1306
Phone (414) 219-7956

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
65212WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Apr 3, 2018 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jun 20, 2016 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 3, 2018 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

945 N 12th St
Ste 2110
Milwaukee, WI 53233
Phone (414) 219-6809

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

950 N 12th St
Milwaukee, WI 53233
Phone (414) 219-6036

1218 W Kilbourn Ave
Milwaukee, WI 53233
Phone (414) 219-7343

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: lko176915@direct.myadvocateaurora.org

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 4

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1467624197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250",
            "fax_number": "414-747-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 S LAKE DR",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103171",
            "telephone_number": "414-744-6589",
            "fax_number": "414-747-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "LAAM",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101017757",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "65212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100056527",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2000 E Layton Ave",
            "city": "St Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lko176915@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2000 E Layton Ave",
            "city": "St Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cudahy, WI

Sources for this page

Verify at the official NPI Registry.