NPIMap

Organization Active NPI

Lake Hospital System Inc

  • General Acute Care Hospital
  • Willoughby, OH
National Provider Identifier
1972689172
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
LAKE HOSPITAL SYSTEM INC
Practice address
36000 Euclid Ave
Willoughby, OH 44094-4662
Phone
(440) 953-9600
Fax
(440) 953-6081
NPI assigned
Oct 31, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Anthony Schrillero
Title
Director of Financial Planning
Phone
(216) 767-8141

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • New Manna CLG, LLC
    • General Acute Care Hospital
    • Beachwood, OH
    • NPI 1841789427

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners 130

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

View all 130

Affiliated clinicians 953

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 953

Care Compare: Hospital

Medicare Care Compare
Listed as
Lake HealthCCN 360098
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Lake Hospital SystemCCN 36T098
Ownership
Non-profit
Certified
Jan 1, 2004

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2322142Lake Health Interventional Psychiatry36000 Euclid Ave, Suite 97-5-05B, Willoughby, OH 44094Certificate of waiverApr 15, 2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20080112000144 OH Part a Provider - Hospital 6002713922 Practice locations: Willowick, OH; Chardon, OH; Willoughby, OH; Mentor, OH; Madison, OH; Concord TWP, OH; Concord Township, OH
O20091030000232 OH Part a Provider - Hospital 6002713922 Practice locations: Concord TWP, OH
O20091030000251 OH Part a Provider - Hospital 6002713922 Practice locations: Concord TWP, OH

Hospital certification: CCN 360098

Medicare enrollment files
Legal name
LAKE HOSPITAL SYSTEM, INC.
Doing business as
LAKE HEALTH
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 5, 2013
Beds
399 (379 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 28, 1983 in OH
Enrollment address
36000 Euclid Ave
Willoughby, OH 44094-4625
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Psychiatric unit, Rehabilitation unit

Hospital certification: CCN 36S098

Medicare enrollment files
Legal name
LAKE HOSPITAL SYSTEM, INC.
Doing business as
LAKE HEALTH CENTER FOR GERIATRIC PSYCHIATRY
Organization structure
CorporationNon-profit
Incorporated
Jul 28, 1983 in OH
Enrollment address
10977 Capital Pkwy
Concord TWP, OH 44077-9394
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Hospital certification: CCN 36T098

Medicare enrollment files
Legal name
LAKE HOSPITAL SYSTEM, INC.
Doing business as
LAKE HEALTH
Organization structure
CorporationNon-profit
Incorporated
Jul 28, 1983 in OH
Enrollment address
10977 Capital Pkwy
Concord TWP, OH 44077-9394
Hospital Rehabilitation Unit
Hospital subgroups
General, Acute care, Psychiatric unit, Rehabilitation unit

All disclosed owners & managing parties 22

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John J Baniewicz Individual Corporate OfficerChief Medical Officer-Community Hos Dec 4, 2014
W-2 Managing EmployeeChief Medical Officer-Community Hos Dec 4, 2014
University Hospitals Health System Inc Organization, Shaker Heights, OH Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 16, 2021 100%
Operational/Managerial Control Apr 16, 2021 100%
Sarah Jeanne Cannon Individual Corporate OfficerDirector, Finance Jun 1, 2023
W-2 Managing EmployeeDirector, Finance Jun 1, 2023
Robyn H Strosaker Individual Corporate OfficerPresident and Chief Operating Offic Jun 1, 2022
W-2 Managing EmployeePresident and Chief Operating Offic Jun 1, 2022
W-2 Managing EmployeePresident and Coo Jun 1, 2022
Corporate OfficerPresident/Ceo Jun 1, 2022
W-2 Managing EmployeePresident/Ceo Jun 1, 2022
Michelle Gallucci Individual Corporate OfficerVP Chief Accounting Officer Oct 22, 2025
Corporate OfficerVP Chief Accounting Officer Oct 23, 2025
Alan Papa Individual Corporate DirectorBoard Member May 18, 2022
Daniel Lee Wilson Individual Corporate DirectorBoard Member May 13, 2021
Richard D Cicero Individual Corporate OfficerVice President, Strategy & Partners Mar 1, 2007
W-2 Managing EmployeeVice President, Strategy & Partners Mar 1, 2007
Chetan P Patel Individual Corporate DirectorBoard Member Mar 1, 2019
Danielle Chickarella Individual Corporate DirectorBoard Member Apr 7, 2022
Anthony Schillero Individual Corporate OfficerDirector of Financial Planning and Jun 23, 2023
W-2 Managing EmployeeDirector of Financial Planning and Jan 17, 2021
Paul Robert Hinchey Individual Corporate DirectorBoard Member Apr 16, 2021
Raymond Paganini Individual Corporate DirectorBoard Member Jan 30, 2019
Thomas Jubeck Individual Corporate DirectorBoard Member Mar 1, 2018
Dawn Gubanc-Anderson Individual Corporate DirectorBoard Member Mar 1, 2017
Brett S Himes Individual Corporate DirectorBoard Member Mar 1, 2017
Keith Ziegler Individual Corporate DirectorBoard Member Mar 1, 2019
Lisa Marie Klammer Individual Corporate DirectorBoard Member Sep 23, 2021
Michael Mayher Individual Corporate DirectorBoard Member May 17, 2010
Paul Tait Individual Corporate DirectorBoard Member Apr 16, 2021
Raymond E Sines Individual Corporate DirectorBoard Member Mar 1, 2018
David a Steiger Individual Corporate DirectorBoard Member Mar 27, 2015

All facility ownership & control disclosures 1

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lake Health Beachwood Medical CenterBeachwood, OH, CCN 360367 Hospital 5% Or Greater Direct Ownership Interest (51%)
Operational/Managerial Control (100%)		 Jan 17, 2017
Jan 17, 2017

National Provider Directory

National Provider Directory
Tax ID family
Lake Medical Center37 organizations share this tax ID

Corporate family (same tax ID) 36

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

View all 36

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X
Rehabilitation Hospital Unit 273Y00000X
General Acute Care Hospital 282N00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

36000 Euclid Ave
Willoughby, OH 44094-4662

Mailing address

PO Box 772930
Detroit, MI 48277-2930
Phone (440) 953-9600

Other identifiers 14

NPPES NPI Registry
IdentifierTypeStateIssuer
0140D446MedicaidKY
807020000MedicaidID
816807662AMedicaidGA
XHSP33687MedicaidCA
10024977600MedicaidNE
XHSP43687MedicaidCA
016066904MedicaidMT
803272MedicaidAZ
909509800MedicaidFL
0011437050002MedicaidPA
4922507MedicaidOH
D2490320MedicaidNY
LAK0098NMedicaidAL
3600098MedicaidNC

Other names 1

NPPES NPI Registry
  • Lake Health Doing business as

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 18, 2025.

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1972689172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772930",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772930",
            "telephone_number": "440-953-9600",
            "fax_number": "440-953-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944662",
            "telephone_number": "440-953-9600",
            "fax_number": "440-953-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HOSPITAL SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "SCHRILLERO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCIAL PLANNING",
        "authorized_official_telephone_number": "216-767-8141",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0140D446",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807020000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "816807662A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP33687",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024977600",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP43687",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016066904",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803272",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "909509800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011437050002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4922507",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D2490320",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAK0098N",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3600098",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD EMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lake Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.