NPIMap

Organization Active NPI

Lakes Anesthesia

  • Anesthesiology Physician
  • Franklin Lakes, NJ
National Provider Identifier
1154862738
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
LAKES ANESTHESIA
Practice address
833 Franklin Ave
Franklin Lakes, NJ 07417-1410
Phone
(201) 847-8079
Fax
(201) 847-0059
NPI assigned
Mar 15, 2017
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Kareem Eltaki, MDNPI 1013181221
Title
Ceo
Phone
(201) 847-8079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

833 Franklin Ave
Franklin Lakes, NJ 07417-1410

Mailing address

PO Box 629
Franklin Lakes, NJ 07417-0629
Phone (201) 847-8079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171110000924 NY Part B Supplier - Clinic/Group Practice 8123384997 Receives reassigned benefits from 6 practitioners
Practice locations: Nanuet, NY
O20200204002312 NJ Part B Supplier - Clinic/Group Practice 8123384997 Receives reassigned benefits from 5 practitioners
Practice locations: Montvale, NJ

National Provider Directory

National Provider Directory

Locations

55 Old Turnpike Rd
Ste 605
Nanuet, NY 10954
Phone (845) 623-4069

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1154862738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074170629",
            "telephone_number": "201-847-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 FRANKLIN AVE",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171410",
            "telephone_number": "201-847-8079",
            "fax_number": "201-847-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-15",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "ELTAKI",
        "authorized_official_first_name": "KAREEM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-847-8079",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.