NPIMap

Individual provider Active NPI

Lawrence John Maciolek, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Glendale, WI
National Provider Identifier
1811925381
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
45567-20 Issued in WI
Practice address
525 W River Woods Parkway
Suite 130
Glendale, WI 53212
Phone
(414) 961-0304
Fax
(414) 961-2061
NPI assigned
Jun 30, 2006
Last updated
Nov 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 45567-020 WI
Orthopaedic Surgery of the Spine Physician 207XS0117X 45567-20 WI Primary

Addresses

Primary practice location

525 W River Woods Parkway
Suite 130
Glendale, WI 53212

Mailing address

575 W River Woods Pkwy
Suite 100
Glendale, WI 53212-1003
Phone (414) 332-6262

Other identifiers 1

IdentifierTypeStateIssuer
34908400MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070720000409 WI Practitioner - Orthopedic Surgery 1355345653 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Wisconsin School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspen Orthopaedic and Rehabilitation Specialists S CGroup PAC ID 8325930480, 11 clinicians
Wisconsin Bone and Joint S CGroup PAC ID 9234107749, 21 clinicians

Practice addresses (Care Compare)

12555 W National Ave
Suite 100
New Berlin, WI 53151-4061
Phone (262) 799-5605

2500 N Mayfair Rd
Suite 500
Wauwatosa, WI 53226-1415
Phone (414) 257-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
20.06 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
66.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion38
Laminectomy or laminotomy (partial removal of spine bones)15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45567-020WIMDOrthopaedic Surgery Physician
45567-20WIMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Current Accepting new patients
Aspen Orthopaedic and Rehabilitation Specialists S C Orthopaedic Surgery CurrentSince Apr 1, 2011 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Dec 1, 2011 Accepting new patients
Wisconsin Bone & Joint S C Orthopaedic Surgery CurrentSince Jan 1, 2018 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Dec 1, 2011 Accepting new patients
Wisconsin Bone & Joint S C Orthopaedic Surgery CurrentSince Jan 1, 2018 Accepting new patients
Blount Orthopaedic Associates, S.C. Orthopaedic Surgery PastSince Aug 1, 2007 Accepting new patients
Paul Glazer, M.D., P.C. Orthopaedic Surgery of the Spine Past Accepting new patients
Massachusetts General Physicians Organization Inc Orthopaedic Surgery Past Accepting new patients

Locations

17000 W North Ave
Ste 104W
Brookfield, WI 53005
Phone (262) 395-4141

525 W River Woods Pkwy
Ste 130
Glendale, WI 53212
Phone (414) 961-0304

575 W River Woods Pkwy
Ste 100
Glendale, WI 53212
Phone (414) 332-6262

12555 W National Ave
Ste 100
New Berlin, WI 53151
Phone (262) 395-4141

2500 N Mayfair Rd
Ste 500
Wauwatosa, WI 53226
Phone (414) 257-1772

2500 N Mayfair Rd
Ste 550
Wauwatosa, WI 53226
Phone (414) 257-2525

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 9

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1811925381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 W RIVER WOODS PKWY",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121003",
            "telephone_number": "414-332-6262",
            "fax_number": "414-332-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W RIVER WOODS PARKWAY",
            "address_2": "SUITE 130",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53212",
            "telephone_number": "414-961-0304",
            "fax_number": "414-961-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIOLEK",
        "first_name": "LAWRENCE",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "45567-020",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "WI",
            "license": "45567-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34908400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

Verify at the official NPI Registry.