Lisa Bennett, MD | |
10320 N Port Washington Rd, Mequon, WI 53092-5767 | |
(262) 241-1919 | |
(262) 241-9046 |
Full Name | Lisa Bennett |
---|---|
Gender | Female |
Speciality | Ophthalmology |
Experience | 9 Years |
Location | 10320 N Port Washington Rd, Mequon, 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 |
---|---|---|---|
1619354743 | NPI | - | NPPES |
1619354743 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 2016014173 (Missouri) | Secondary |
207W00000X | Ophthalmology | 70489 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Ascension Columbia St Mary's Hospital Milwaukee | Milwaukee, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Madison Medical Affiliates Inc | 5991606337 | 84 |
Entity Name | Madison Medical Affiliates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588695746 PECOS PAC ID: 5991606337 Enrollment ID: O20040119000018 |
Mailing Address | Practice Location Address |
---|---|
Lisa Bennett, MD 788 N Jefferson St Ste 300, Milwaukee, WI 53202-3710 Ph: (414) 272-8950 | Lisa Bennett, MD 10320 N Port Washington Rd, Mequon, WI 53092-5767 Ph: (262) 241-1919 |
Mrs. Martha F Jay, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 11307 N Port Washington Rd, Mequon, WI 53092 Phone: 262-241-1919 Fax: 262-241-9046 | |
John E. Ridley Iii, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 824 W Sierra Ln, Mequon, WI 53092 Phone: 262-241-4622 |