Lakewood ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LAKEWOOD ASC, LLC

Practice address

5571 E Sr 44 Ste 501
Wildwood, FL 34785-8282

Phone

(352) 643-9080

Fax

(352) 571-6786

NPI assigned

Oct 29, 2018

Last updated

Oct 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jose A Rivera

Title

Administrator

Phone

(352) 643-9080

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Lakewood ASC LLCCCN 10C0001659

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 3

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

• Heart of the Villages PLC

  • Cardiovascular Disease Physician
  • The Villages, FL
  • NPI 1659671774

  Member Of

  NPD member
• Tri-County Heart Institute PA

  • Specialist
  • Lady Lake, FL
  • NPI 1063967149

  Member Of

  NPD member
• Vladmir J. Vlcko DO, P.a

  dba Citrus Medical Associates

  • Family Medicine Physician
  • Inverness, FL
  • NPI 1154344125

  Member Of

  NPD member

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 1

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.

• Abel Rivero, M.D.

  • Interventional Cardiology Physician
  • The Villages, FL
  • NPI 1659531937
  NPD (past)

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1821565706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5571 E SR 44 STE 501",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858282",
            "telephone_number": "352-643-9080",
            "fax_number": "352-571-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5571 E SR 44 STE 501",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858282",
            "telephone_number": "352-643-9080",
            "fax_number": "352-571-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-643-9080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Eun Kim
• Stephanie Kitos, APRN FNP-BC
• Kuhn Chiropractic PA
• David C Kuhn, DC
• La Plus Family Investment (Active Therapy)
• Lakewood CCL, LLC
• Maria Jarosch Largent, M.S., CCC-A
• Tasha Lasane
• Jowatha Maner Lee
• Leonidas Vitality Health Clinic

• Ambulatory Surgical Clinic/Center in Wildwood, FL
• Providers in Wildwood, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.