Lake Point Medical Group, LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

LAKE POINT MEDICAL GROUP, LLC

Practice address

15800 Detroit Ave Ste B
Lakewood, OH 44107-3749

Phone

(216) 363-2353

Fax

(216) 696-7375

NPI assigned

Jan 1, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth Khuri, LPCCNPI 1265988133

Title

Managing Member

Phone

(216) 307-7651

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Lake Point Medical Group, LLC

  • Podiatrist
  • Cleveland, OH
  • NPI 1982161527

  6002177342

  Same PAC ID

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 8

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

• Elizabeth R. Khuri, MA,LPC

  • Mental Health Counselor
  • Beachwood, OH
  • NPI 1265988133
  Medicare reassignment Care Compare group NPD Authorized official
• Mina Ghassemi

  • Foot & Ankle Surgery Podiatrist
  • Lakewood, OH
  • NPI 1447747597
  Medicare reassignment Care Compare group NPD
• Michelle Hisako Haldeman, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Lakewood, OH
  • NPI 1669851812

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Isaac Korb

  • Podiatrist
  • Middleburg Heights, OH
  • NPI 1164171377
  Medicare reassignment Care Compare group NPD
• Kristina Marie Kovach, DPM

  • Podiatrist
  • Lakewood, OH
  • NPI 1669465142
  Medicare reassignment Care Compare group NPD
• Amber Stonehouse Tully, M.D.

  • Family Medicine Physician
  • Rocky River, OH
  • NPI 1215144506
  Medicare reassignment Care Compare group NPD
• Carmen Rivero Carland, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lakewood, OH
  • NPI 1790480333
  NPD (past)
• Habibeh Gitiforooz, MD

  • Obstetrics & Gynecology Physician
  • Lakewood, OH
  • NPI 1912959909
  NPD (past)

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

{
    "created_epoch": "1514764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1235646191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15800 DETROIT AVE STE B",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073749",
            "telephone_number": "216-307-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 DETROIT AVE STE B",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073749",
            "telephone_number": "216-363-2353",
            "fax_number": "216-696-7375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24600 Center Ridge Rd Ste 275",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441455679",
            "country_code": "US",
            "telephone_number": "216-307-7651",
            "fax_number": "216-221-3171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1730 W 25th St",
            "address_2": "Health Center",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441133108",
            "country_code": "US",
            "telephone_number": "216-363-2353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE POINT MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-01",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "KHURI",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "216-307-7651",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Thomas Lackey, PHD.
• Julia Lacomb, DO
• Abby C Lader, D.O.
• Lake County Foot & Ankle Associates, LLC
• Lake Lactation LLC
• Emily Stice Laker
• Lakewest DBT Center LLC
• Lakewood City Center Dental LLC
• Lakewood City SD
• Lakewood Cleveland Clinic Hospital

• Podiatrist in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.