Organization Active NPI

Lake City Outpatient Anesthesia PLLC

  • Anesthesiology Physician
  • Lake City, FL
National Provider Identifier
1316171010
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
LAKE CITY OUTPATIENT ANESTHESIA PLLC
Practice address
4367 NW American LN
Lake City, FL 32055-4828
Phone
(386) 487-3930
NPI assigned
May 8, 2009
Last updated
Aug 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Collin Lemaistre
Title
Officer/Authorized Official
Phone
(214) 213-0732

Specialties & licenses 1

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

Addresses

Primary practice location

4367 NW American LN
Lake City, FL 32055-4828

Mailing address

4367 NW American LN
Lake City, FL 32055-4828
Phone (386) 487-3930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251028002664 FL Part B Supplier - Clinic/Group Practice 0749779098 Receives reassigned benefits from 5 practitioners
Practice locations: Lake City, FL

National Provider Directory

National Provider Directory
Tax ID family
Lake City Outpatient Anesthesia2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://73a16b75-76ae-4370-af3f-78876c5948e6.gastro.prod.fhir.ema-api.com/fhir/r4/

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1316171010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4367 NW AMERICAN LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554828",
            "telephone_number": "386-487-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4367 NW AMERICAN LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554828",
            "telephone_number": "386-487-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY OUTPATIENT ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-08",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "LEMAISTRE",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-213-0732"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.