NPIMap

Organization Active NPI

Lakeside Orthopedic Institute LLC

Doing business as Lakeside Urgent Care

  • Urgent Care Clinic/Center
  • Lake Havasu City, AZ
National Provider Identifier
1972373710
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LAKESIDE ORTHOPEDIC INSTITUTE LLC
Doing business as
Lakeside Urgent Care
Practice address
1944 Mesquite Ave
Lake Havasu City, AZ 86403-5729
Phone
(928) 505-5555
NPI assigned
Jan 3, 2024
Organization subpart
Yes
Parent organization
LAKESIDE ORTHOPEDIC INSTITUTE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

Name
Daniel Edward Heiner, MD
Title
Managing Partner
Phone
(928) 505-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1944 Mesquite Ave
Lake Havasu City, AZ 86403-5729

Mailing address

25 Riviera Blvd
Lake Havasu City, AZ 86403-5694
Phone (928) 505-5555

Other names 1

  • Lakeside Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060918000307 AZ Part B Supplier - Clinic/Group Practice 1052316445 Receives reassigned benefits from 14 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Quartzite, AZ; Lake Havasu City, AZ; Bullhead City, AZ

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Silver State Surgery Center7 organizations share this tax ID, including this one
Part of
Silver State Surgery Center

Other organizations with this tax ID 6

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

Member organizations 1

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1972373710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 RIVIERA BLVD",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035694",
            "telephone_number": "928-505-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 MESQUITE AVE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035729",
            "telephone_number": "928-505-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE ORTHOPEDIC INSTITUTE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKESIDE ORTHOPEDIC INSTITUTE LLC",
        "enumeration_date": "2024-01-03",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "HEINER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "928-505-5555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.