Lake Surgical Associates, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

LAKE SURGICAL ASSOCIATES, LLC

Practice address

10110 Donald Powers Dr.
Ste. 202
Munster, IN 46321

Phone

(219) 922-0222

Fax

(219) 922-8899

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Russell W Pellar, M.D.NPI 1346298676

Title

Doctor

Phone

(219) 922-0222

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Russell W Pellar, MD

  • Surgery Physician
  • Munster, IN
  • NPI 1346298676
  NPD (past) Authorized official

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1275673865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 DONALD POWERS DR.",
            "address_2": "STE. 202",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "46321",
            "telephone_number": "219-922-0222",
            "fax_number": "219-922-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 DONALD POWERS DR.",
            "address_2": "STE. 202",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "46321",
            "telephone_number": "219-922-0222",
            "fax_number": "219-922-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "PELLAR",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "219-922-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD IL",
            "identifier": "90001007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "CH5506",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Henry Ladaga, CRNA
• Sueyi Lai, MD
• Leslie Lair, NP-C
• Lake County Cardiology and Internal Medicine PC
• Lake Ridge Pediatric Dentistry, Inc
• Lake Urology LLC
• Amy Lynne Lambert
• Elvia Lamegos
• Michael Jennings Lane Sr., DNP PMHNP-BC
• John Langford, MD

• Surgery Physician in Munster, IN
• Providers in Munster, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.