Lisa Marie Sladek, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003881 Issued in MI

Practice address

55 Campau Ave NW
Suite 10
Grand Rapids, MI 49503-2642

Phone

(616) 459-7380

Fax

(616) 459-5752

NPI assigned

Feb 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Lisa Marie Kommer Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carlson Eye Care, LLCGroup PAC ID 5597157891, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drsladek@andersoneye.direct.eyemdemr.com

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.

• Carlson Eye Care, LLC

  • Optometrist
  • Grand Rapids, MI
  • NPI 1215605134
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1548396294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CAMPAU AVE NW",
            "address_2": "SUITE 10",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032642",
            "telephone_number": "616-459-7380",
            "fax_number": "616-459-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CAMPAU AVE NW",
            "address_2": "SUITE 10",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032642",
            "telephone_number": "616-459-7380",
            "fax_number": "616-459-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADEK",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900D114630",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "KOMMER",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kira Elizabeth Skorupski
• Zdravko Skrtic, MD
• Katherine Alexandra Skurski, D.O.
• Sky Stonez
• Philip Scott Slachter, LMSW
• Hien T Slagel, PHARM. D.
• Dianne Slager, FNP
• Tracy Norris Slager, LPC
• William Slager
• Mitike Slagstad

• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.