LAKE ENDOSCOPY CENTER LLC NPI 1750823886

NPI Information

NPI: 1750823886
Provider Name: LAKE ENDOSCOPY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Specialization: Ambulatory Surgical
Entity Type: Organization
CLIA Number: 10D1074553
Address: 17355 SE 109TH TERRACE RD
SUMMERFIELD, FL
ZIP 34491
Phone: (352) 245-0846

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NPI Details

LAKE ENDOSCOPY CENTER, LLC is an ambulatory surgical clinic center in Summerfield, FL. LAKE ENDOSCOPY CENTER, LLC NPI is 1750823886. The provider is registered as an organization entity type.

The provider's business location address is:

17355 SE 109TH TERRACE RD
SUMMERFIELD, FL
ZIP 34491-930
Phone: (352) 245-0846

The provider's authorized official is Collin Lemaistre .
The authorized official title is Officer/authorized Official and has the following contact phone number (404) 781-2921.

The CLIA number assigned to this NPI record is 10D1074553 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
Insertion of guide wire with dilation of esophagus using a flexible endoscope (HCPCS:43248)
Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
Biopsy of lower large bowel using a flexible endoscope (HCPCS:45331)
Insertion of sacral nerve neurostimulator electrode array (HCPCS:64561)
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43235)
Diagnostic exam of lower portion of large bowel using a flexible endoscope (HCPCS:45330)
Injection beneath lining of large bowel using a flexible endoscope (HCPCS:45381)

The enumeration date for this NPI number is 11/7/2016 and was last updated on 10/11/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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