Shanon Renee Lacy, D.O.
NPI 1003076142ActiveIndividual· Pathology, Anatomic Pathology & Clinical Pathology· West Allis, WI
Pathology, Anatomic Pathology & Clinical Pathology (D.O.) in West Allis, Wisconsin, trained at Chicago College of Medicine and Surgery (class of 2007). Medicare paid $83,416 for services to 1,762 patients in 2024.
Overview
| NPI | 1003076142 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.O. |
| Sole proprietor | No |
| NPI issued | Jun 12, 2008 |
| Last updated in NPPES | Dec 30, 2021 |
| Certified by provider | Dec 30, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pathology, Anatomic Pathology & Clinical Pathology Primary | 207ZP0102X | 56999-21 | WI |
| Pathology, Dermatopathology | 207ZD0900X | 56999-21 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Pathology (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 1,762 |
|---|---|
| Services billed | 3,361 across 17 procedure codes |
| Paid by Medicare | $83,416 |
Education and affiliations
| Medical school | Chicago College of Medicine and Surgery |
|---|---|
| Graduation year | 2007 |
| Medicare specialty | Pathology |
Medical group
- Great Lakes Pathologists SCBurlington, WI · 55 clinicians
Hospital affiliations
- Aurora Baycare Medical CtrGreen Bay, WI
- Aurora Medical Center - SummitSummit, WI
- Aurora Medical Center KenoshaKenosha, WI
- Aurora St Lukes Medical CenterMilwaukee, WI
- Waukesha Memorial HospitalWaukesha, WI
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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