Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Agnes Prospere, MD

Individual provider Family Medicine Physician · NPI 1083241301

Dr. Agnes Prospere, MD is a Family Practice in Oak Creek, Wisconsin. Qualified in 2019, 7 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

200 E Ryan Rd
Oak Creek, WI 53154-4563
Phone: (414) 570-3590
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2901 W Oklahoma Ave, Milwaukee, WI 53215-4329 — (414) 649-6732

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 80102-20 (WI)

Record details

NPI number1083241301
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 25, 2020
Last updated in NPPESOctober 26, 2023
Certification dateOctober 26, 2023
Mailing addressPo Box 735044, Chicago, IL 60673-4329

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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