Lake Terrace Nursing and Rehab LLC
NPI 1053803031ActiveOrganization· Skilled Nursing Facility· Milwaukee, WI
Skilled Nursing Facility in Milwaukee, Wisconsin, registered in NPPES in June 2018. The authorized official on file is Max Stesel, Owner. Enrolled in Medicare as part a provider - skilled nursing facility and part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1053803031 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 5, 2018 |
| Last updated in NPPES | Sep 16, 2020 |
| Certified by provider | Sep 16, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | 3150 | 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 Part A Provider - Skilled Nursing Facility (WI); Part B Supplier - Physical/Occupational Therapy Group in Private Practice (WI) |
|---|
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