Great Lakes Surgery LLC
NPI 1629518006 · Ambulatory Surgical Clinic/Center · Kenosha, WI
Great Lakes Surgery LLC is a Ambulatory Surgical Clinic/Center organization in Kenosha, WI (NPI 1629518006).
Provider details
- NPI number
- 1629518006
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- John Bostanche, Director(262) 657-0224
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-03-03
- Last updated
- 2017-03-03
Frequently asked questions
- What is Great Lakes Surgery LLC's NPI number?
- Great Lakes Surgery LLC's National Provider Identifier (NPI) is 1629518006, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Lakes Surgery LLC?
- Great Lakes Surgery LLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Great Lakes Surgery LLC located?
- Great Lakes Surgery LLC's practice location on file with NPPES is 6123 Green Bay Rd Ste 101, Kenosha, WI 53142-2927.
- What is Great Lakes Surgery LLC's phone number?
- The practice phone number listed in the NPPES registry for Great Lakes Surgery LLC is (262) 657-0224.
- Who is the authorized official for Great Lakes Surgery LLC?
- The authorized official listed on Great Lakes Surgery LLC's NPPES record is John Bostanche, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Lakes Surgery LLC's NPI active?
- Yes — Great Lakes Surgery LLC's NPI (1629518006) is active in the NPPES registry as of the last update on 2017-03-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.