Lakeshore Medical Clinic, LLC
NPI 1003861188ActiveOrganization· Family Medicine· Saint Francis, WI
Family Medicine in Saint Francis, Wisconsin, registered in NPPES in May 2006. The authorized official on file is Kara Richardson, Assistant Treasurer. Enrolled in Medicare as mdpp supplier - in-person mdpp supplier and part b supplier - clinic/group practice.
Overview
| NPI | 1003861188 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 24, 2006 |
| Last updated in NPPES | Oct 3, 2025 |
| Certified by provider | Oct 3, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center | 261Q00000X | — | — |
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 Mdpp Supplier - In-Person Mdpp Supplier (WI); Part B Supplier - Clinic/Group Practice (WI); Part B Supplier - Physical/Occupational Therapy Group in Private Practice (WI) |
|---|
Other family medicine physicians in Saint Francis
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