Kathleen Lynn Lak, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

59950 Issued in WI

Practice address

9200 W Wisconsin Ave
Department of Surgery
Milwaukee, WI 53226-3522

Phone

(414) 805-5700

Fax

(414) 454-0152

NPI assigned

Mar 29, 2011

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

• Kathleen Lynn Simon Former name

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

Specialty

General Surgery

Education

Medical College of Wisconsin, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177
• Community Memorial Hospital Hospital, Menomonee Falls, WI, CCN 520103

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klakmd233014@direct.froedtert.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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Surgery

  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• The Medical College of Wisconsin Inc

  • Case Management Agency
  • Milwaukee, WI
  • NPI 1649521105
  NPD (past)

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

• Community Memorial Hospital of Menomonee Falls Inc

  • General Acute Care Hospital
  • Menomonee Falls, WI
  • NPI 1609822881
  Care Compare affiliation
• Froedtert Memorial Lutheran Hospital, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1578852620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5700",
            "fax_number": "414-454-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5700",
            "fax_number": "414-454-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAK",
        "first_name": "KATHLEEN",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "59950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578852620",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "SIMON",
            "middle_name": "LYNN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laidbackrides LLC
• Jacob Laine, M.D.
• Christopher Laird, MD
• Stacy Laird, PHARM D
• Shelley Laitinen, CCC-SLP
• Anne E B Lakatos, APN-BC, APNP, RN
• Lake Park Dental LLC
• Lake Terrace Nursing and Rehab LLC
• Jacqueline Lake, NP
• Jodi Jay Lake, R.N.

• Surgery Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; 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.