LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES
NPI 1003924739
Clinic/Center - Multi-Specialty in Holland, MI
About Lakeshore Internal Medicine And Pediatric Associates NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES (NPI 1003924739) is a healthcare organization registered as a multi-specialty in Holland, Michigan and active in the NPI registry since August 2006. The organization lists Barbara Martin, Billing, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 8
Accepted Insurance
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)
Lakeshore Internal Medicine And Pediatric Associates is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 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
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Lakeshore Internal Medicine And Pediatric Associates, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: 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 Lakeshore Internal Medicine And Pediatric Associates's NPI number?
The NPI number for Lakeshore Internal Medicine And Pediatric Associates is 1003924739. It was assigned to this organization in the NPPES registry on August 25, 2006.
Where is Lakeshore Internal Medicine And Pediatric Associates located?
Lakeshore Internal Medicine And Pediatric Associates is located at 437 North 120th Ave, Holland, MI 49424. The listed phone number is (616) 738-0737.
What is Lakeshore Internal Medicine And Pediatric Associates's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Lakeshore Internal Medicine And Pediatric Associates enrolled in Medicare?
Yes. Lakeshore Internal Medicine And Pediatric Associates is registered in the Medicare PECOS enrollment system.
When is Lakeshore Internal Medicine And Pediatric Associates'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 (Michigan, Clinic/Group Practice) is due for revalidation by March 31, 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 Lakeshore Internal Medicine And Pediatric Associates?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Internal Medicine, reassign their Medicare billing to Lakeshore Internal Medicine And Pediatric Associates. 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. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Lakeshore Internal Medicine And Pediatric Associates accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lakeshore Internal Medicine And Pediatric Associates as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Lakeshore Internal Medicine And Pediatric Associates was last updated on June 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Lakeshore Internal Medicine And Pediatric Associates · NPI 1003924739
Multi-Specialty organization in Holland, Michigan. Organization record, active in the CMS NPPES registry since August 25, 2006.
## Identity
- **NPI:** 1003924739 (Entity type: Organization)
- **Enumerated:** August 25, 2006
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Barbara Martin, BILLING
## Practice location
- **Address:** 437 NORTH 120TH AVE, Holland, MI 49424
- **Phone:** (616) 738-0737
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 7, 2016
- **Other identifiers:** Medicare UPIN G96493 (MI); Medicaid 4531728 (MI); Medicaid 4529541 (MI); and 5 more
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Source: [NPI Profile](https://npiprofile.com/npi/1003924739) · Data from the CMS NPPES public registry.