Lakeside Internal Medicine, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKESIDE INTERNAL MEDICINE, PLLC

Practice address

10450 E Riggs Rd
Suite 110
Sun Lakes, AZ 85248-7757

Phone

(480) 895-7600

Fax

(480) 895-7601

NPI assigned

Jul 25, 2013

Last updated

Jul 31, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Philip L Ku, M.D.NPI 1376558775

Title

Owner/Member

Phone

(480) 895-7600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Philip L Ku, M.D.

  • Internal Medicine Physician
  • Sun Lakes, AZ
  • NPI 1376558775
  Medicare reassignment Care Compare group Authorized official
• Jennifer L Cool, M.D.

  • Internal Medicine Physician
  • Sun Lakes, AZ
  • NPI 1528067477
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1063854420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 E RIGGS RD",
            "address_2": "SUITE 110",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487757",
            "telephone_number": "480-895-7600",
            "fax_number": "480-895-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 E RIGGS RD",
            "address_2": "SUITE 110",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487757",
            "telephone_number": "480-895-7600",
            "fax_number": "480-895-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE INTERNAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "KU",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "480-895-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khatali Headache and Pain Treatment Center LLC
• Hal L Kime, D.O.
• Nilanjana Kothari
• Philip L Ku, M.D.
• Brianne Nicole Labella
• Deana Elaine Laster, BEHAVIORAL TECHNICIA
• Toh-Hoai W. Lim, I, M.D.
• Nancy Jane Martin, CCC-SP
• Murphy G McCarty, PT, DPT
• Jennifer S McDonald, MD

• Internal Medicine Physician in Sun Lakes, AZ
• Providers in Sun Lakes, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.