Lakeside Medical Care PLLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

266476-1 Issued in NY

Legal business name

LAKESIDE MEDICAL CARE PLLC

Practice address

8746 Erie Rd
Suite a
Angola, NY 14006-9620

Phone

(716) 549-4999

Fax

(716) 549-4998

NPI assigned

Sep 28, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Troy Sasse, D.O.

Title

Physician

Phone

(716) 549-4999

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jordan Davies

  • Physical Therapy Assistant
  • Angola, NY
  • NPI 1851847636
  NPD (past)

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1215307657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8746 ERIE RD",
            "address_2": "SUITE A",
            "city": "ANGOLA",
            "state": "NY",
            "postal_code": "140069620",
            "telephone_number": "716-549-4999",
            "fax_number": "716-549-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8746 ERIE RD",
            "address_2": "SUITE A",
            "city": "ANGOLA",
            "state": "NY",
            "postal_code": "140069620",
            "telephone_number": "716-549-4999",
            "fax_number": "716-549-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "SASSE",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "716-549-4999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NY",
            "license": "266476-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4529111 TYPE 2",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Jeffries
• Kristin Jordan
• Heather Lynn Kerr-Puleo
• Lauren Marie Kilian
• Carley Kless, OTR/L
• Caitlin E Mann Pauszek
• Lisa N Mann, LMHC, CASAC, MSED
• Susan J Manzella
• Matthew Martin, OCCUPATIONAL THERAPY
• Amanda Martinez

• All providers in Angola, NY
• Urgent Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.