LAKE MEDICAL GROUP (MELCHOR SIPALAY MD LLC) NPI 1003012279

Internal Medicine in Pueblo, CO

NPI 1003012279 Organization Internal Medicine

About LAKE MEDICAL GROUP (MELCHOR SIPALAY MD LLC)

Lake Medical Group (melchor Sipalay Md Llc) is an internal medicine provider established in Pueblo, Colorado specializing in internal medicine. The NPI number of Lake Medical Group (melchor Sipalay Md Llc) is 1003012279 and was assigned on June 2007. The practitioner's primary taxonomy code is 207R00000X with license number 38338 (CO). The provider is registered as an organization and their NPI record was last updated 14 years ago. Lake Medical Group (melchor Sipalay Md Llc) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Lake Medical Group. The authorized official of this NPI record is Dr. Melchor Sipalay M.d. (Owner)

An internist like Lake Medical Group is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

NPI

1003012279

Provider NameLAKE MEDICAL GROUP (MELCHOR SIPALAY MD LLC)
Provider Location Address2001 LAKE AVE PUEBLO, CO 81004
Provider Mailing Address2001 LAKE AVE PUEBLO, CO 81004
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameLAKE MEDICAL GROUP
Other Name TypeDoing Business As (3)
Enumeration Date06-25-2007
Last Update Date05-16-2008


Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.38338
License StateCO
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Business Address

LAKE MEDICAL GROUP
2001 LAKE AVE
PUEBLO, CO
ZIP 81004
Phone: (719) 564-0300
Fax: (719) 564-0303

Get Directions


Mailing Address

LAKE MEDICAL GROUP
2001 LAKE AVE
PUEBLO, CO
ZIP 81004
Phone: (719) 564-0300
Fax: (719) 564-0303



Authorized Official

Authorized Official NameDR. MELCHOR SIPALAY M.D.
Authorized Official TitleOWNER
Authorized Official Phone(719) 564-0300

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
C475348MEDICARE PIN (08)CO
H14258MEDICARE UPIN (02)CO
56483872MEDICAID (05)CO

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1669442422 KRYSTAL J HOLDERNESS NAKAMURA M.D.
Individual
Dermatology2001 LAKE AVE
PUEBLO, CO 81004
(719) 564-5544
1437108131 KYRA K HOOTMAN DO
Individual
Internal Medicine2001 LAKE AVE
PUEBLO, CO 81004
(719) 564-0300
1497912851LARRY D WALLS MD PROF LLC
Organization
Internal Medicine2001 LAKE AVE
PUEBLO, CO 81004
(719) 564-0300
1558528919KYRA HOOTMAN DO PC
Organization
Internal Medicine2001 LAKE AVE
PUEBLO, CO 81004
(719) 564-0300
1922351279INFECTIOUS DISEASE SPECIALIST OF SOUTHERN COLORADO, PLLC
Organization
Clinic/Center2001 LAKE AVE SUITE 2
PUEBLO, CO 81004
(719) 582-8425

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.