Lake Endocrinology and Diabetes, PLLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

LAKE ENDOCRINOLOGY AND DIABETES, PLLC

Doing business as

Lake Endocrinology Consulting, PLLC

Practice address

13123 66TH St
Largo, FL 33773-1812

Phone

(727) 477-1039

Fax

(727) 477-0498

NPI assigned

Mar 12, 2017

Organization subpart

No

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

Authorized official

Name

Brian Matthew Lake, DONPI 1295887040

Title

Ambr

Phone

(727) 477-1039

Specialties & licenses 2

Addresses

Other names 1

• Lake Endocrinology Consulting, PLLC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

Interoperability endpoints

• Direct secure messaging: brian.lake@lead.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/GDJCCD

Practitioners 4

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

• Brian Matthew Lake, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Largo, FL
  • NPI 1295887040
  Medicare reassignment Care Compare group NPD Authorized official
• Kimberley Joyce Philip, APRN

  • Adult Health Nurse Practitioner
  • Largo, FL
  • NPI 1538130919
  Medicare reassignment Care Compare group NPD
• Dmitry A. Grebenev, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Largo, FL
  • NPI 1528003043
  Medicare reassignment NPD
• Melanie Scala, APRN

  • Gerontology Nurse Practitioner
  • Palm Harbor, FL
  • NPI 1174358519
  Medicare reassignment NPD

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

{
    "created_epoch": "1489276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619913600000",
    "number": "1619418563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13123 66TH ST",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337731812",
            "telephone_number": "727-477-1039",
            "fax_number": "727-477-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 66TH ST",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337731812",
            "telephone_number": "727-477-1039",
            "fax_number": "727-477-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ENDOCRINOLOGY AND DIABETES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-12",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "AMBR",
        "authorized_official_telephone_number": "727-477-1039",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "OS9591",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.lake@lead.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Lake Endocrinology and Diabetes, PLLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13123 66th St",
            "city": "Largo",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337731812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lake Endocrinology Consulting, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Guy P Lafond, M.D.
• Doris Maricel Carandang Lagat, APRN
• Kendra Pritchard Lagrande, P.T.
• Melissa Leeann Lahmeyer, AP
• Tiffany Laitano, MD
• Lake House Assisted Living LLC
• Brian Matthew Lake, D.O.
• Lakeside Occuapatinal Medical Centers Inc
• Lakeside Occupational Medical Centers, Inc.
• Lakeside of Lakeland Inc

• Endocrinology, Diabetes & Metabolism Physician in Largo, FL
• Providers in Largo, FL by specialty
• Endocrinology, Diabetes & Metabolism Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; 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.