EC LASER AND SURGERY INSTITUTE OF WI, LLC (NPI# 1215283866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215283866 |
| Entity Type | Organization |
| Organization Name | EC LASER AND SURGERY INSTITUTE OF WI, LLC |
| Practice Address |
800 N 1st St Suite 100 Wausau WI 54403-4754 |
| Practice Telephone | 7152618500 |
| Mailing Telephone | 7152985500 |
| Mailing Fax Number | 7152985506 |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2013-03-14 |
| Authorized Official Name | DR. ROBERT N BEAUCHENE (OWNER/MEMBER) |
| Authorized Official Telephone | 7152985500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | PTAN | W12972 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EC LASER AND SURGERY INSTITUTE OF WI, LLC | 800 N 1st St Ste 10, Wausau, WI 54403-4754 |
| Street Address |
800 N 1ST ST SUITE 100 |
| City | WAUSAU |
| State | WI |
| Zip Code | 54403-4754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780071662 | John Alexander Flatter | Ophthalmology | 800 N 1st St, Wausau, WI 54403-4754 | 2015-04-18 |
| 1710390331 | Afua Annor Shin | Ophthalmology | 800 N 1st St, Wausau, WI 54403 | 2014-06-11 |
| 1083024574 | Deepak Sambhara | Ophthalmology | 800 N 1st St, Wausau, WI 54403-4754 | 2014-05-06 |
| 1164773685 | Thomas Boostrom | Nurse Anesthetist, Certified Registered | 800 N 1st St, Wausau, WI 54403-4754 | 2012-09-24 |
| 1831446707 | Jennifer Nicole Marcell | Optometrist | 800 N 1st St, Wausau, WI 54403-4754 | 2012-08-10 |
| 1033371745 | Christopher J Kucharski | Ophthalmology | 800 N 1st St, Wausau, WI 54403-4754 | 2008-06-25 |
| 1063612497 | Benjamin Reed Clark | Optometrist | 800 N 1st St, Wausau, WI 54403-4754 | 2007-07-24 |
| 1912101213 | Mathew Warren Aschbrenner | Ophthalmology | 800 N 1st St, Wausau, WI 54403-4754 | 2007-06-12 |
| 1700985645 | Matthew James Johnson | Optometrist | 800 N 1st St, Wausau, WI 54403-4754 | 2006-09-21 |
| 1235156985 | Lori J Rogers-fish | Audiologist | 800 N 1st St, Wausau, WI 54403-4754 | 2006-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932714292 | Human Services Board Serving North Central Health Care Facility | Special Hospital | 2380 Marshall St., Wausau, WI 54403 | 2020-09-14 |
| 1396129755 | Aimee Budleski | Counselor | 530 Grant Street, Wasuau, WI 54403 | 2015-07-16 |
| 1467861328 | Nevin Grossnickle | Massage Therapist | 319 4th Street, Ll, Wausau, WI 54403 | 2014-08-05 |
| 1609297860 | Brian Christus | Counselor | 209 West Washington Street Suite B., Wausau, WI 54403 | 2013-12-13 |
| 1376983676 | Jacqueline J Streveler | Counselor | 741 N First St, Wausau, WI 54403 | 2013-07-01 |
| 1033468947 | Tonia Yvette Backman | Social Worker | 1810 North 2nd Street, Wausau, WI 54403 | 2012-09-06 |
| 1730436551 | Ashley L Schulz | Registered Nurse | 1005 Colonial Rd, Wausau, WI 54403 | 2012-08-10 |
| 1093061939 | Kimberly Gilray | Physical Therapist | 1100 Lakeview Drive, Wausau, WI 54403 | 2012-07-30 |
| 1841594603 | Daniel L. Schaut | Dentist | 1723 Mulligan Dr., Wausau, WI 54403 | 2011-01-07 |
| 1982836813 | Eric J Gabrielsen | Dentist | 200 E. Bridge St., Ste-100, Wausau, WI 54403 | 2009-08-11 |
| Find all providers in zip 54403 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669787958 | Pine Ridge Surgery Center, LLC | Clinic/Center | 2500 Pine Ridge Blvd, Wausau, WI 54401-0000 | 2010-08-11 |
| 1053585125 | Bjosc, LLC | Clinic/Center | 225000 Hummingbird Rd Ste 300, Wausau, WI 54401-2950 | 2008-04-18 |
| 1851356786 | Wausau Surgery Center Lp | Clinic/Center | 2809 Westhill Dr, Wausau, WI 54401-3700 | 2006-04-20 |
| 1316206972 | Pain Centers of Wisconsin - Wausau, LLC | Clinic/Center | 400 Westwood Dr, Suite 200, Wausau, WI 54401-7801 | 2012-05-16 |
| 1962663559 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 411 Westwood Dr, Wausau, WI 54401 | 2008-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113841 | Spine Solutions of West Bend LLC | Clinic/Center | 1000 Gateway Ct Ste 200, West Bend, WI 53095-8541 | 2020-10-29 |
| 1205454626 | Eye Surgery Center of Wisconsin, LLC | Clinic/Center | 10148 S 27th St, Oak Creek, WI 51354 | 2020-07-13 |
| 1083242325 | Appleton Surgical Center LLC | Clinic/Center | 1616 N Casaloma Dr # 200, Appleton, WI 54913-8245 | 2020-03-31 |
| 1164056974 | Orthopedic Surgery Center of The Fox Valley LLC | Clinic/Center | 1205 W. American Drive, Neenah, WI 54596-5459 | 2020-03-02 |
| 1013548833 | Ascension Wisconsin Surgery Center-mount Pleasant LLC | Clinic/Center | 10180 Washington Ave Ste 200, Mount Pleasant, WI 53177-1604 | 2020-01-30 |
| 1497393516 | Aurora Surgery Centers, LLC | Clinic/Center | 12500 Aurora Drive, Pleasant Prairie, WI 53158 | 2019-12-19 |
| 1275178444 | Kenosha Digestive Health Center LLC | Clinic/Center | 8220 75th St, Kenosha, WI 53142-7637 | 2019-11-12 |
| 1851887715 | Southern Lakes Endoscopy LLC | Clinic/Center | 240 Maple Ave Ste 2220, Mukwonago, WI 53149-8475 | 2018-07-03 |
| 1447768411 | Wisconsin Institute of Surgical Excellence LLC | Clinic/Center | 1265 W American Dr Ste 200, Neenah, WI 54956 | 2018-01-12 |
| 1629518006 | Great Lakes Surgery LLC | Clinic/Center | 6123 Green Bay Rd Ste 101, Kenosha, WI 53142-2927 | 2017-03-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EC LASER AND SURGERY INSTITUTE OF WI, LLC.
| 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.