Lakeshore Eye Care Professionals, S.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

LAKESHORE EYE CARE PROFESSIONALS, S.C.

Practice address

10320 N Port Washington Rd
Mequon, WI 53092-5767

Phone

(262) 241-1919

Fax

(262) 241-9046

NPI assigned

Apr 18, 2007

Organization subpart

No

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

Authorized official

Name

Linda L. Knapp

Title

Office Manager

Phone

(262) 241-1919

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deborah Costakos, M.D.

  • Ophthalmology Physician
  • Milwaukee, WI
  • NPI 1568466928
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1568688331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 N PORT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925767",
            "telephone_number": "262-241-1919",
            "fax_number": "262-241-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 N PORT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925767",
            "telephone_number": "262-241-1919",
            "fax_number": "262-241-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE EYE CARE PROFESSIONALS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "KNAPP",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "262-241-1919"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100005006",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie J Laabs Siemon, MS
• Brianna Labarbera
• Thomas John Labisch, DPT
• Kristen E Lachapell, MS, GNP-BC, APNP
• Luke Laga
• Lakeshore Medical Clinic
• Lakeshore Psychology Services LLC
• Lakeshore Veins S. C.
• Lakeshore Veins S. C.
• Angela M Lancaster, NP

• Ophthalmology Physician in Mequon, WI
• Providers in Mequon, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.