LAKE HOSPITAL SYSTEM (NPI# 1710295829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710295829 |
| Entity Type | Organization |
| Organization Name | LAKE HOSPITAL SYSTEM |
| Other Organization Name | LAKE HEALTH PHYSICIAN GROUP ELECTROPHYSIOLOGY |
| Practice Address |
36100 Euclid Ave Suite 400 Willoughby OH 44094-4456 |
| Mailing Address |
Po Box 714328 Columbus OH 43271-4328 |
| Practice Telephone | 4406026735 |
| Practice Fax Number | 4409463221 |
| Mailing Telephone | 4406026735 |
| Mailing Fax Number | 4409463221 |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |
| Authorized Official Name | MR. ROBERT TRACZ (CFO) |
| Authorized Official Telephone | 4403541642 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Lake Health Physician Group Electrophysiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942580394 | Lake Hospital System | Family Medicine | 8316 Yellowbrick Rd, Mentor, OH 44060-4960 | 2011-08-17 |
| 1326141987 | Lake Hospital System | Internal Medicine | 29804 Lakeshore Blvd, Willowick, OH 44095 | 2006-09-07 |
| 1255394136 | Lake Hospital System | Dietitian, Registered | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2006-04-11 |
| 1346202512 | Lake Hospital System | General Acute Care Hospital | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2006-04-04 |
| Street Address |
36100 EUCLID AVE SUITE 400 |
| City | WILLOUGHBY |
| State | OH |
| Zip Code | 44094-4456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508859497 | Khalil Azem | Otolaryngology | 36100 Euclid Ave, Ste 350, Willoughby, OH 44094-4456 | 2005-08-25 |
| 1649711870 | Sabina Sibi | Nurse Practitioner | 36100 Euclid Ave, #350, Willoughby, OH 44094-4456 | 2017-03-20 |
| 1013310051 | Kimberly Salcer | Nurse Practitioner | 36100 Euclid Ave, Suite 270, Willoughby, OH 44094-4456 | 2014-10-06 |
| 1174963235 | Kristan J. Bryant | Nurse Practitioner | 36100 Euclid Ave, Suite 400, Willoughby, OH 44094-4456 | 2013-07-03 |
| 1427310168 | Cleveland Advanced Surgical LLC | Surgery | 36100 Euclid Ave, Suite 330b, Willoughby, OH 44094-4456 | 2012-06-08 |
| 1558651968 | Cleveland Eye Care & Surgery, Inc. | Ophthalmology | 36100 Euclid Ave, Suite 450, Willoughby, OH 44094-4456 | 2011-04-19 |
| 1922308774 | Eastside Primary Care LLC | Internal Medicine | 36100 Euclid Ave, #430, Willoughby, OH 44094-4456 | 2010-10-27 |
| 1013227628 | George Eli Drogomir | Internal Medicine | 36100 Euclid Ave, Suite 170, Willoughby, OH 44094-4456 | 2010-10-15 |
| 1073839783 | Boris Vinogradsky Md Inc | Surgery | 36100 Euclid Ave, Willoughby, OH 44094-4456 | 2010-04-20 |
| 1225263528 | Paul R Zellers | Internal Medicine | 36100 Euclid Ave, Willoughby, OH 44094-4456 | 2009-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574367 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 36596 Euclid Ave, Willoughby, OH 44094 | 2020-09-25 |
| 1679111322 | Megan King | Nurse Practitioner | 4078 Erie Street, Unit B, Willoughby, OH 44094 | 2019-12-12 |
| 1124661525 | Mind and Body Infusion Therapies, LLC | Clinic/Center | 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 | 2019-10-18 |
| 1679125637 | Christina Maria Chandler | Family Medicine | 39021 Signature Circle, Willoughby, OH 44094 | 2019-07-10 |
| 1467920595 | Rachel Curry | Specialist/Technologist | 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 | 2018-11-07 |
| 1437649753 | Katie Lauren Greenaway | Registered Nurse | 5103 Robinhood Dr, Willoughby, OH 44094 | 2018-05-11 |
| 1003346131 | Heather Marie Hayes | Licensed Practical Nurse | 38882 Mentor Ave., Willoughby, OH 44094 | 2017-06-12 |
| 1609305028 | Ann Marie Mason | Counselor | 38882 Mentor Avenue, Willoughby, OH 44094 | 2017-06-08 |
| 1285173005 | Mattie Diann Towns-scott | Social Worker | 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 | 2017-02-13 |
| 1447797329 | Therese Benz | General Acute Care Hospital | 96000 Euclid Ave., Willoughby, OH 44094 | 2017-01-30 |
| Find all providers in zip 44094 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033727292 | Dayton Cardiology Consultants, LLC | Internal Medicine | 6635 Centerville Business Pkwy, Centerville, OH 45459-2655 | 2020-07-14 |
| 1285918706 | The Dayton Heart Center, Inc. | Internal Medicine | 742 Sweitzer St, Greenville, OH 45331-1099 | 2011-10-03 |
| 1275817793 | The Dayton Heart Center, Inc. | Internal Medicine | 6623 Centerville Business Pkwy, Centerville, OH 45459-2655 | 2011-10-03 |
| 1720378243 | Ismail Hamam | Internal Medicine | 473 West 12th Ave, Dhlri 200, Columbus, OH 43210 | 2011-04-18 |
| 1073769709 | Dina Marie Sparano | Internal Medicine | 6801 Mayfield Rd Ste 300, Mayfield Heights, OH 44124 | 2008-08-13 |
| 1518137017 | Bryan Baranowski | Internal Medicine | Cleveland Clinic F15 Mailing Desk, 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2008-03-11 |
| 1821287509 | Shervin Sadrpour | Internal Medicine | 4760 E. Galbraith Road, Suite 205, Cincinnati, OH 45236-6704 | 2007-10-18 |
| 1366504599 | Ottorino Costantini | Internal Medicine | 2500 N Metrohealth Drive, Cleveland, OH 44109 | 2006-12-14 |
| 1780623645 | Firas M.a. Hamdan | Internal Medicine | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2006-06-06 |
| 1669458733 | Fort Wayne Cardiology Corporation | Internal Medicine | 11558 Sr 111, Paulding, OH 45879 | 2005-12-20 |
| Find all providers with the same taxonomy | ||||
| City | WILLOUGHBY |
| Zip Code | 44094 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.