DR. LEE MICHAEL TISA (NPI# 1184930745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184930745 |
| Entity Type | Individual |
| Full Name | DR. LEE MICHAEL TISA |
| Credential | D.P.M. |
| Practice Address |
502 Sue Ann Dr Lake Geneva WI 53147-2341 |
| Practice Telephone | 2622489727 |
| Mailing Telephone | 2622489727 |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2010-08-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 016-003410 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 016003410 | 05 |
| Street Address |
502 SUE ANN DR |
| City | LAKE GENEVA |
| State | WI |
| Zip Code | 53147-2341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951206 | Emily Tanis | Physical Therapist | 6722 Wi-50, Lake Geneva, WI 53147 | 2020-08-05 |
| 1588295653 | Baylee M Noe | Occupational Therapy Assistant | Sage Meadow of Lake Geneva 6722 Wi-50, Lake Geneva, WI 53147 | 2020-01-28 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1386969400 | Emily Kathleen Wilczak | Surgery | N2950 Wi-67, Lake Geneva, WI 53147 | 2010-03-31 |
| 1538294020 | Dale Alan Miller | Pharmacist | 2950 St. Hwy. 67, Lake Geneva, WI 53147 | 2007-02-23 |
| 1689779902 | Balistreri & Associates Physical Therapy | Physical Therapist | 902 Wells Street, Lake Geneva, WI 53147 | 2006-09-13 |
| 1336157981 | Nestor C Alabarca | Internal Medicine | 146 E Geneva Square, Lake Geneva, WI 53147 | 2006-08-03 |
| 1144259375 | Kim M. Cuculi | Occupational Therapist | 800 Geneva Pkwy N Ste 3, Lake Geneva, WI 53147 | 2006-07-01 |
| 1396253571 | Amar Y. Patel | Family Medicine | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2018-01-22 |
| 1679017925 | Christina L. Clancy | Nurse Practitioner | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2016-12-06 |
| Find all providers in zip 53147 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053472076 | Mark E Pfeifer | Podiatrist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1588282453 | Family Foot and Ankle Clinic LLC | Podiatrist | 1021 Western Ave Ste C, Mosinee, WI 54455-1511 | 2020-07-08 |
| 1376161240 | Family Foot and Ankle Clinic LLC | Podiatrist | 1439 Churchill St Ste 202, Waupaca, WI 54981-2089 | 2020-07-08 |
| 1083237754 | Baycare Clinic LLP | Podiatrist | 630 Riverfront Dr, Sheboygan, WI 53081-4615 | 2020-05-28 |
| 1922637107 | Torhorst Foot and Ankle Clinic, Sc | Podiatrist | 2823 Post Rd, Stevens Point, WI 54481-6416 | 2020-04-08 |
| 1528446713 | Jonathan Shih | Podiatrist | 9200 W Loomis Rd Ste 116, Franklin, WI 53132 | 2015-05-08 |
| 1912310152 | Wyatt Isaac Wiedenfeld | Podiatrist | 853 S Main St, Oconto Falls, WI 54154-1203 | 2014-06-05 |
| 1710397039 | Kristina Lorene Thompson | Podiatrist | 37868 Us-18, Prairie Du Chien, WI 53821 | 2014-05-08 |
| 1972856169 | Midwest Foot and Wound Care Center LLC | Podiatrist | W3853 Stoneridge Dr, Fond Du Lac, WI 54937-6201 | 2012-10-25 |
| 1073880936 | Tahir A Khan | Podiatrist | 6001 W Center St Ste 108, Milwaukee, WI 53210-2154 | 2011-11-21 |
| Find all providers with the same taxonomy | ||||
| City | LAKE GENEVA |
| Zip Code | 53147 |
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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.