LAKESIDE FAMILY MEDICINE-UPMC
NPI 1003228172
Family Medicine in Conneaut Lake, PA
About Lakeside Family Medicine-upmc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE FAMILY MEDICINE-UPMC (NPI 1003228172) is a healthcare organization registered as a family medicine in Conneaut Lake, Pennsylvania and active in the NPI registry since May 2014. The organization lists Mark Ehalt, Sr.director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lakeside Family Medicine-upmc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
1,179Medicare enrollment records show 1,179 clinicians reassign Medicare billing to Lakeside Family Medicine-Upmc, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 38
Nearest to this location (20)
See all 1,179Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Upmc Community Medicine Inc's NPI number?
The NPI number for Upmc Community Medicine Inc is 1003228172. It was assigned to this organization in the NPPES registry on May 23, 2014. The provider is also known as Lakeside Family Medicine-Upmc.
Where is Upmc Community Medicine Inc located?
Upmc Community Medicine Inc is located at 11065 State Highway 18 Suite 1, Conneaut Lake, PA 16316. The listed phone number is (814) 382-6550.
What is Upmc Community Medicine Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Upmc Community Medicine Inc enrolled in Medicare?
Yes. Upmc Community Medicine Inc is registered in the Medicare PECOS enrollment system.
When is Upmc Community Medicine Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Upmc Community Medicine Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1,179 clinicians in 38 Medicare specialties reassign their Medicare billing to Upmc Community Medicine Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (320), Internal Medicine (243) and Nurse Practitioner (194). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Upmc Community Medicine Inc was last updated on May 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lakeside Family Medicine-Upmc · NPI 1003228172
Family Medicine organization in Conneaut Lake, Pennsylvania. Organization record, active in the CMS NPPES registry since May 23, 2014.
## Identity
- **NPI:** 1003228172 (Entity type: Organization)
- **Enumerated:** May 23, 2014
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Upmc Community Medicine Inc
- **Organization subpart:** No
- **Authorized official:** Mark Ehalt, SR.DIRECTOR
## Practice location
- **Address:** 11065 STATE HIGHWAY 18, SUITE 1, Conneaut Lake, PA 16316-3569
- **Phone:** (814) 382-6550
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Pennsylvania, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1,179 clinicians in 38 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (320), Internal Medicine (243), Nurse Practitioner (194); 1 practice within 10 miles; [full list](https://npiprofile.com/npi/1003228172/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 23, 2014
- **Other identifiers:** Medicare PIN 042490 (PA)
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Source: [NPI Profile](https://npiprofile.com/npi/1003228172) · Data from the CMS NPPES public registry.