| Lara N Mrak, MD | |
|
1032 E Sumner St, Hartford, WI 53027-1608 | |
| (262) 673-2300 | |
| Not Available |
| Full Name | Lara N Mrak |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 12 Years |
| Location | 1032 E Sumner St, Hartford, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063832608 | NPI | - | NPPES |
| 100047720 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 66081 (Wisconsin) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 66081 - 20 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Aurora Medical Center - Summit | Summit, WI | Hospital |
| Aurora St Lukes Medical Center | Milwaukee, WI | Hospital |
| West Allis Memorial Hospital | West allis, WI | Hospital |
| Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
| Aurora Memorial Hospital Burlington | Burlington, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Advanced Healthcare, Inc. | 3375625833 | 1012 |
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Entity Name | Lakeshore Medical Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
| Entity Name | Aurora Advanced Healthcare, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
| Mailing Address | Practice Location Address |
|---|---|
| Lara N Mrak, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Lara N Mrak, MD 1032 E Sumner St, Hartford, WI 53027-1608 Ph: (262) 673-2300 |
Mr. Luis A Sosa Lozano, M.D Radiology Medicare: Accepting Medicare Assignments Practice Location: 1640 E Sumner St, Hartford, WI 53027 Phone: 262-670-4000 |