Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Eric Wideburg, DO

Individual provider Diagnostic Radiology Physician · NPI 1679004469

Eric Wideburg, DO practises Diagnostic Radiology in Waukesha, Wisconsin. Graduated from Des Moines University of Osteopathic Medicine and Health Sciences in 2017, 9 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
9
Trained at
Des Moines University of Osteopathic Medicine and Health Sciences
Licensed in
WI
In the registry since
2017
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

W231N1440 Corporate Ct
Waukesha, WI 53186-1303
Phone: (262) 896-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 — (414) 955-4575
  • 10945 N Port Washington Rd Ste 201, Thiensville, WI 53092-5078 — (262) 292-3151

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 72422-21 (WI)

Record details

NPI number1679004469
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 23, 2017
Last updated in NPPESMarch 27, 2025
Certification dateMarch 27, 2025

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolDES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduated 2017 (9 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients1,582
Services billed 3,217 a service is one billed item, such as a visit, a test or a procedure
Average patient age75

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Lakeshore Medical Clinic LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 379 clinicians in the practice; 12 are shown here.

Other providers in Waukesha