| Emilio Lastarria, MD | |
|
158 North St, Geneva, NY 14456-1647 | |
| (315) 719-0066 | |
| (315) 719-0373 |
| Full Name | Emilio Lastarria |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 41 Years |
| Location | 158 North St, Geneva, New York |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760587125 | NPI | - | NPPES |
| 271102800 | Medicaid | FL | |
| P00082844 | Other | FL | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 74228 (Wisconsin) | Primary |
| 208800000X | Urology | 173332 (New York) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Marshfield Medical Center | Marshfield, WI | Hospital |
| Marshfield Medical Center - Neillsville | Neillsville, WI | Hospital |
| Entity Name | Marshfield Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952347981 PECOS PAC ID: 2264345206 Enrollment ID: O20031106000590 |
| Entity Name | Beaver Dam Community Hospitals Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972188555 PECOS PAC ID: 2567370539 Enrollment ID: O20040210000666 |
| Entity Name | Mchs Hospitals Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093221434 PECOS PAC ID: 5698071173 Enrollment ID: O20180208000096 |
| Mailing Address | Practice Location Address |
|---|---|
| Emilio Lastarria, MD 35 Mason St, Suite 214, Geneva, NY 14456-1133 Ph: (315) 230-5646 | Emilio Lastarria, MD 158 North St, Geneva, NY 14456-1647 Ph: (315) 719-0066 |
Richard Kasulke, MD Urology Medicare: Medicare Enrolled Practice Location: 200 North St, Suite 101, Geneva, NY 14456 Phone: 315-787-5100 Fax: 315-787-5108 |