Brookdale Lakeway LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BROOKDALE LAKEWAY LLC

Doing business as

Brookdale Lakeway
Brookdale Lakeway I

Practice address

1915 Lohmans Crossing Rd
Lakeway, TX 78734-5274

Phone

(512) 261-7146

NPI assigned

May 18, 2023

Last updated

May 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joanne Leskowicz

Title

Senior Vice President

Phone

(414) 918-5000

Specialties & licenses 2

Addresses

Other names 2

• Brookdale Lakeway Doing business as
• Brookdale Lakeway I Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912698077. Details of each certification follow.

• CCN 676657 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 676657

Legal name

BROOKDALE THERAPY LAKEWAY

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Apr 12, 2007

Last certification

Aug 22, 2016

Ownership / control type

Proprietary

Facility address

1915 Lohmans Crossing Road
Lakeway, TX 78734

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1912698077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST STE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145650",
            "telephone_number": "414-918-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 LOHMANS CROSSING RD",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787345274",
            "telephone_number": "512-261-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKDALE LAKEWAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "LESKOWICZ",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Lakeway",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookdale Lakeway I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kohldon Carter Boydston, MD
• Dana Brauman, PSYD
• Brent Bennett MD PA
• Brianda Hernandez PLLC (Highland Family Dentistry)
• Colin Broadbelt, P.T.
• Kristopher Matthew Brown, AU.D.
• Madison Brunner, DPT
• Lanny B. Brustein, DC
• BTB Lakeway Inc (Lakeway Pharmacy)
• Rachel Lynne Buechler, DDS

• Assisted Living Facility in Lakeway, TX
• Providers in Lakeway, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.