Individual provider Active NPI

Lisa Dickas

  • Speech-Language Pathologist
  • Weston, WI
National Provider Identifier
1962737114
Registry record updated Oct 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1929-154 Issued in WI
Practice address
3401 Cranberry Blvd
Weston, WI 54476-5217
Phone
(715) 393-2100
NPI assigned
Oct 6, 2009
Last updated
Oct 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1929-154 WI Primary

Addresses

Primary practice location

3401 Cranberry Blvd
Weston, WI 54476-5217

Mailing address

2805 Partridge Way
Wausau, WI 54401-1201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201207003128 WI Practitioner - Qualified Speech Language Pathologist 4981016425 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1929-154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Sep 30, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 27, 2020 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Sep 30, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 27, 2020 Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 27, 2020 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

3401 Cranberry Blvd
Weston, WI 54476
Phone (715) 393-2000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1962737114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 PARTRIDGE WAY",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544011201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765217",
            "telephone_number": "715-393-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKAS",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1929-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.