DR. JONATHAN TYLER LAACK (D.O.) – Emergency Medicine Physician, NPI 1487090072

DR. JONATHAN TYLER LAACK (D.O.) is a healthcare provider. based in Weston, Wisconsin. specializing in Emergency Medicine Physician. They hold the professional credentials D.O.. They hold a License No. 5101020493 (MI). The NPI Number for DR. JONATHAN TYLER LAACK (D.O.) is 1487090072

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. JONATHAN TYLER LAACK (D.O.)
NPI
1487090072
Phone
(715) 393-3000
Address
3400 MINISTRY PKWY
Enumeration Date
22 May 2013
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7153933000
Graduation Year
2013 (13 years ago)
PAC ID
7911209879
Group Practice PAC ID
1355392887
Professional Enrollment ID
I20170711001590

Contacts

Secure Messaging
him@marshfieldclinichealthsystem.cernerdirect.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:13State licenses:2Other namesUpdated within 12 months

Provider Addresses for DR. JONATHAN TYLER LAACK (D.O.)

  • 3400 MINISTRY PKWY

    WESTON, WI 544765220

    Phone: (715) 393-3000

    Type: Mailing

  • 1234 Napier Ave

    Saint Joseph, MI 490852112

    Phone: (269) 982-4941

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-07-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170711001590IEmergency MedicineWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making141130$0
99284Emergency department visit with moderate level of medical decision making9997$0
99283Emergency department visit with low level of medical decision making6763$0
99291Critical care, first 30-74 minutes2120$0
99282Emergency department visit with straightforward medical decision making1212$0
View full utilization report →

Insurance plans in this area (ZIP 54476)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355392887View full group profile

Reviews

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Frequently asked questions

Where can patients find DR. JONATHAN TYLER LAACK (D.O.)'s NPI?
You can confirm DR. JONATHAN TYLER LAACK (D.O.) with NPI 1487090072; it appears in the national provider directory.
Is DR. JONATHAN TYLER LAACK (D.O.)'s NPI currently valid?
The extract we use shows DR. JONATHAN TYLER LAACK (D.O.) as active.
What field does DR. JONATHAN TYLER LAACK (D.O.) work in?
You can think of DR. JONATHAN TYLER LAACK (D.O.) as practicing within Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is DR. JONATHAN TYLER LAACK (D.O.)'s primary listing?
We display Weston, Wisconsin because that is what the record indicates for DR. JONATHAN TYLER LAACK (D.O.).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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