Individual provider Active NPI

Laura M Ozimek, PA-C

  • Physician Assistant
  • Brookfield, WI
National Provider Identifier
1720215353
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2419 Issued in WI
Practice address
13800 W North Ave Ste 100
Brookfield, WI 53005-4977
Phone
(262) 754-4488
Fax
(262) 754-4940
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2419 WI Primary

Addresses

Primary practice location

13800 W North Ave Ste 100
Brookfield, WI 53005-4977

Mailing address

13800 W North Ave Ste 100
Brookfield, WI 53005-4977
Phone (262) 754-4488

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vsanchez@affiliatedderm.com Direct Affiliated Dermatologists SC

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090717000124 WI Practitioner - Physician Assistant 7517019805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Dermatologists SCGroup PAC ID 8123065794, 12 clinicians

Practice addresses (Care Compare)

13800 W N Ave
Suite 100
Brookfield, WI 53005-4977
Phone 2627544488119

Merit-based Incentive Payment System (MIPS)

Final score
91.13 of 100Reported as group
Quality
90.63
Improvement activities
40
Cost
82.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Dermatologists, SC CurrentSince May 6, 2019 Accepting new patients

Locations

13800 W North Ave
Ste 100
Brookfield, WI 53005
Phone (262) 754-4488

14555 W National Ave
Ste 190
New Berlin, WI 53151
Phone (262) 754-4488

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1720215353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054977",
            "telephone_number": "262-754-4488",
            "fax_number": "262-754-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054977",
            "telephone_number": "262-754-4488",
            "fax_number": "262-754-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZIMEK",
        "first_name": "LAURA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vsanchez@affiliatedderm.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Affiliated Dermatologists SC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13800 W North Ave Ste 100",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530054977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.