Organization Active NPI

Lake America Family Physicians LLC

  • Family Medicine Physician
  • Clermont, FL
National Provider Identifier
1518370147
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 117575 Issued in FL
Legal business name
LAKE AMERICA FAMILY PHYSICIANS LLC
Practice address
865 Oakley Seaver Dr
Clermont, FL 34711-1968
Phone
(352) 432-3939
NPI assigned
Jun 11, 2014
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Amit Aggarwal, M.D.NPI 1326368234
Title
President
Phone
(618) 520-5368

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
Family Medicine Physician 207Q00000X ME 117575 FL Primary

Addresses

Primary practice location

865 Oakley Seaver Dr
Clermont, FL 34711-1968

Mailing address

1055 Glenraven LN
Clermont, FL 34711-9012
Phone (618) 520-5368

Other practice location 1

1920 Don Wickham Dr
Suite 335
Clermont, FL 34711-1918
Phone (407) 259-2013

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141027000734 FL Part B Supplier - Clinic/Group Practice 1153542626 Receives reassigned benefits from 7 practitioners
Practice locations: Clermont, FL

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

301 Frontage Rd
Unit G
Clermont, FL 34711
Phone (352) 432-3939

Practitioners & affiliated clinicians

Practitioners 7

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": "1402444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1518370147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 GLENRAVEN LN",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347119012",
            "telephone_number": "618-520-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111968",
            "telephone_number": "352-432-3939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 Don Wickham Dr",
            "address_2": "Suite 335",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347111918",
            "country_code": "US",
            "telephone_number": "407-259-2013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE AMERICA FAMILY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-11",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "AGGARWAL",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-520-5368",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 117575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.