NPIMap

Individual provider Active NPI

Andrew Norbert Laczniak, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1790064905
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2016009489 Issued in MO
Practice address
510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone
(314) 362-7200
Fax
(314) 747-4189
NPI assigned
Aug 5, 2011
Last updated
Sep 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2016009489 MO Primary

Addresses

Primary practice location

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016

Mailing address

660 S Euclid Ave
C B 8131
Saint Louis, MO 63110-1010
Phone (314) 362-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160620001068 MO Practitioner - Diagnostic Radiology 0648409201 Reassigns benefits to 1 organization
I20170615000669 WI Practitioner - Diagnostic Radiology 0648409201 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Radiologists S CGroup PAC ID 1951209311, 58 clinicians
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Jun 20, 2017 Accepting new patients
Beloit Radiology LTD Diagnostic Radiology CurrentSince May 31, 2020 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jun 20, 2017 Accepting new patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Washington University Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients

Locations

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2911

660 S Euclid Ave
#C
Saint Louis, MO 63110

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

800 Clay St
Darlington, WI 53530
Phone (608) 776-4466

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1790064905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8131",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACZNIAK",
        "first_name": "ANDREW",
        "middle_name": "NORBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-05",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2016009489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.