LAKESHORE SURGICAL PRACTICE, PC


Address: 30 Erie Canal Dr, Suite E, Rochester, NY 14626-4604
Phone: 5856372930

LAKESHORE SURGICAL PRACTICE, PC (NPI# 1578998696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578998696
Entity Type Organization
Organization Name LAKESHORE SURGICAL PRACTICE, PC
Practice Address 30 Erie Canal Dr
Suite E
Rochester
NY 14626-4604
Mailing Address 1 Park Ave
Brockport
NY 14420-1913
Practice Telephone 5856372930
Practice Fax Number 5856372930
Mailing Telephone 5856372930
Mailing Fax Number 5855074707
Enumeration Date 2013-09-09
Last Update Date 2013-09-09
Authorized Official Name DR. RICHARD J KING (PHYSICIAN)
Authorized Official Telephone 5856372930
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0102X Surgery
Specialization: Surgical Critical Care
239232 NY Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NY 02752716 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1801173448 Lakeshore Surgical Practice, PC Surgery 156 West Ave, Brockport, NY 14420-1229 2011-11-10

Office Location

Street Address 30 ERIE CANAL DR
SUITE E
City ROCHESTER
State NY
Zip Code 14626-4604

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801894100 Louis Howard Medved Psychiatry & Neurology 30 Erie Canal Dr, Suite G, Rochester, NY 14626-4604 2005-07-11

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760978084 Elizabeth M Neenan Nurse Practitioner 105 Canal Landing Blvd. Suite 1, Rochester, NY 14626 2018-07-10
1811488737 Anthony Richard Mesolella Dentist 2081 W Ridge Rd Ste 204, Rochester, NY 14626 2018-05-26
1285157370 Heather Kate Byam Nurse Anesthetist, Certified Registered 280 Mill Road, Rochester, NY 14626 2017-07-20
1710415039 Abner O De Los Santos Dentist 120 Erie Canal Dr Ste 150, Rochester, NY 14626 2017-05-31
1609308709 Ulfat Shafiq Dentist 1100 Long Pond Rd Ste 115, Greece, NY 14626 2017-03-29
1174982953 S.a.v.o.c L.l.c Preferred Provider Organization 2833 West Ridge Road, Pearle Vision Ridgemont Plaza Suite 'a', Rochester, NY 14626 2016-02-22
1700244357 Kerri Anne Sawyer Registered Nurse 82 Southridge Drive, Rochester, NY 14626 2016-02-10
1518398106 Braces of Greece Exclusive Provider Organization 770 Fetzner Rd., Rochester, NY 14626 2013-12-06
1477983443 Amy Pawlyk Licensed Practical Nurse 116 Annie Lane, Rochester, NY 14626 2013-11-12
1689911208 Kathleen Zimmerman Occupational Therapist 1555 Long Pond Rd., 4th Floor, Rochester, NY 14626 2013-01-16
Find all providers in zip 14626

Taxonomy Information

Taxonomy Code 2086S0102X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Surgical Critical Care

Taxonomy Definition

A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144546995 Michael Antonio Vella Surgery 601 Elmwood Avenue Box Surg, Rochester, NY 14642-0001 2010-04-19
1164076691 Kristen Giberson Surgery 601 Elmwood Ave, Rochester, NY 14642-0001 2019-08-01
1366951998 Kevin Charles Cooper Surgery 601 Elmwood Ave, Rochester, NY 14642-0001 2017-09-27
1689023277 Cardiac Surgery of The University of Rochester Surgery 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 2016-06-06
1851754634 Acute Care Trauma of The University of Rochester Surgery 601 Elmwood Ave, Rochester, NY 14642-0001 2016-03-30
1962644484 Neil Gupta Kumar Surgery 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 2009-03-30
1003829110 Yanjie Qi Surgery 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 2006-08-14
1740205566 University of Rochester Surgical Associates Surgery 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 2006-07-13
1770510836 Paul Edward Bankey Surgery 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 2006-06-26
1417984519 Nicole Anne Stassen-wagner Surgery 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 2006-06-26
Find all providers in ROCHESTER

Competitor

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City ROCHESTER
Zip Code 14626

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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