Lakeshore Medical Clinic, LTD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKESHORE MEDICAL CLINIC, LTD

Practice address

S74W16775 Janesville Rd
Muskego, WI 53150-7742

Phone

(414) 281-1688

NPI assigned

Jun 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Masood Wasiullah, MDNPI 1194803692

Title

President

Phone

(414) 744-6589

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Aurora Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • West Allis, WI
  • NPI 1689146359

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Masood Wasiullah, MD

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1194803692
  Authorized official Same address or phone

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508061995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S74W16775 JANESVILLE RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531507742",
            "telephone_number": "414-281-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S74W16775 JANESVILLE RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531507742",
            "telephone_number": "414-281-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE MEDICAL CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WASIULLAH",
        "authorized_official_first_name": "MASOOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-744-6589",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Kreeger, MS, CCC-SLP
• Kerri Marie Krueger, OTR
• Rachel Elizabeth Kuss, LPC-IT
• Kimberly Ann Lagrow, R.N., FNP-C
• Lakeshore Medical Clinic, LLC
• Regina Angela Lanza, RN
• Carrie L. Lapow, APNP
• Rachel Ann Lauber, LPN
• LBJS SC (Smile Pediatric Dentistry of Muskego)
• David X Lee, BCBA

• Durable Medical Equipment & Medical Supplies in Muskego, WI
• Providers in Muskego, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.