Active NPI
Michael Lewis Laccheo Sr., M.D.
- Family Medicine Physician
- Topeka, KS
National Provider Identifier
1689786386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 19586
- Practice address
- 1119 SW Gage Blvd
Topeka, KS 66604-1999 - Phone
- (785) 271-6000
- Fax
- (785) 271-6321
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19586 | KS | Primary |
Addresses
Primary practice location
1119 SW Gage Blvd
Topeka, KS 66604-1999
Mailing address
1119 SW Gage Blvd
Topeka, KS 66604-1999
Phone (785) 271-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103561 | Other | KS | BLUE AND BLUE SHIELD KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 6, 2015 through Oct 6, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19586 | KS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689786386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1119 SW GAGE BLVD",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666041999",
"telephone_number": "785-271-6000",
"fax_number": "785-271-6321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1119 SW GAGE BLVD",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666041999",
"telephone_number": "785-271-6000",
"fax_number": "785-271-6321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACCHEO",
"first_name": "MICHAEL",
"middle_name": "LEWIS",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "19586",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE AND BLUE SHIELD KS",
"identifier": "103561",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Topeka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.