JOHN LACZKOWSKI (NPI# 1053476085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053476085 |
| Entity Type | Individual |
| Full Name | JOHN LACZKOWSKI |
| Credential | OD |
| Practice Address |
2761 S 108th St West Allis WI 53227-3232 |
| Mailing Address |
11103 West Ave Suite 6 San Antonio TX 78213-1370 |
| Practice Telephone | 4143212425 |
| Practice Fax Number | 4143214647 |
| Mailing Telephone | 2105246663 |
| Mailing Fax Number | 2105246587 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1430-035 | WI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38502300 | 05 |
| Street Address |
2761 S 108TH ST |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227-3232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376624379 | Stein Optical Inc | Eyewear Supplier (Equipment, not the service) | 2761 S 108th St, West Allis, WI 53227-3232 | 2006-10-17 |
| 1104189877 | Daniel Carl Pridemore | Optometrist | 2761 S 108th St, West Allis, WI 53227-3232 | 2012-06-19 |
| 1750668299 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 2761 S 108th St, West Allis, WI 53227-3232 | 2011-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801382445 | Daniel & Max, LLC | Optometrist | 3101 S 108th St, West Allis, WI 53227-4019 | 2018-07-06 |
| 1578687505 | Joan Marie Beyer | Optometrist | 1540 S 108th St, West Allis, WI 53214-4019 | 2007-03-16 |
| 1437165701 | David L Waterfill | Optometrist | 1401 S 108th St, West Allis, WI 53214-4012 | 2006-07-31 |
| 1841294618 | Eric L. Knight | Optometrist | 7300 W Greenfield Ave, West Allis, WI 53214-4729 | 2005-06-09 |
| 1598324154 | Joel Hansen | Optometrist | 7300 W Greenfield Ave, West Allis, WI 53214-4729 | 2019-06-07 |
| 1225414733 | Jeremy Kemmerling | Optometrist | 1401 S 108th St, West Allis, WI 53214-4012 | 2015-08-06 |
| 1104189877 | Daniel Carl Pridemore | Optometrist | 2761 S 108th St, West Allis, WI 53227-3232 | 2012-06-19 |
| 1265698187 | Sara C Falter | Optometrist | 555 S 108th St, West Allis, WI 53214-1145 | 2008-07-30 |
| 1467558536 | Knight Vision & Glaucoma Specialists, Inc. | Optometrist | 7300 W Greenfield Ave, West Allis, WI 53214-4729 | 2006-09-16 |
| 1780652321 | David Scheidt | Optometrist | 10150 W National Ave, West Allis, WI 53227-2145 | 2006-03-09 |
| Find all providers in WEST ALLIS | ||||
| City | WEST ALLIS |
| Zip Code | 53227 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.