LISA LA SUSA (O.D.) – Optometrist, NPI 1730593310

LISA LA SUSA (O.D.) is a healthcare provider. based in West bend, Wisconsin. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 3336-35 (WI). The NPI Number for LISA LA SUSA (O.D.) is 1730593310

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
LISA LA SUSA (O.D.)
NPI
1730593310
Phone
Not provided
Address
1437 S MAIN ST
Enumeration Date
11 June 2014
Last Update Date
11 June 2014

Doctor Profile

Medical School Name
INTERNATIONAL AMERICAN UNIVERSITY AT PUERTO RICO - SCHOOL OF OPTOMETRY
Secondary Phone
2813634362
Graduation Year
2013 (13 years ago)
PAC ID
7517206105
Group Practice PAC ID
7719226489
Professional Enrollment ID
I20190226001105
Address ID
TX773822745TH6700XPKWY301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:12State licenses:2Digital endpointsOther names

798 OPTOMETRY in WI

Provider Addresses for LISA LA SUSA (O.D.)

  • 1437 S MAIN ST

    WEST BEND, WI 530954931

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 15 Open Payments records for all available years, with a total value of $969.

Total Amount is formed as General ($969) + Research ($0) + Ownership ($0) = $969.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Alcon Vision LLC ($413).

Total Amount

$969

General + Research + Ownership

Payments

15

Total payment records

General Amount

$969

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-02-26

PECOS data refreshed: 2026-06-15

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
I20190226001105IOptometryTXTBD

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
92014Established patient complete exam of visual system4848$0
92083Exam of visual field with extended testing4239$0
92250Photography of the retina4139$0
99213Established patient office or other outpatient visit, 20-29 minutes2017$0
92133Imaging of optic nerve1817$0
View full utilization report →

Insurance plans in this area (ZIP 53095)

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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: 7719226489View full group profile
NameSpecialtyState
-TX
O P T O M E T R YTX
O P T O M E T R YCA

Reviews

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Frequently asked questions

Does LISA LA SUSA (O.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — LISA LA SUSA (O.D.) uses 1730593310.
Is LISA LA SUSA (O.D.) listed as active for patients and plans?
The listing shows LISA LA SUSA (O.D.) as active in the NPI system.
What is LISA LA SUSA (O.D.) best known for clinically?
Directory data describes LISA LA SUSA (O.D.) with Optometrist. Clinical services aligned with this taxonomy classification.
Where is LISA LA SUSA (O.D.) based?
LISA LA SUSA (O.D.) is tied to West Bend, Wisconsin in the data we show; additional addresses may exist on the full record.
Why does LISA LA SUSA (O.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.