LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES
NPI 1003924739
Clinic/Center - Multi-Specialty in Holland, MI
NPI Status: Active since August 25, 2006
Contact Information
437 NORTH 120TH AVE
HOLLAND, MI
ZIP 49424
Phone: (616) 738-0737
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- CLIA Number: 23D0967100
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-02-2025
About LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES
This page provides the complete NPI Profile along with additional information for Lakeshore Internal Medicine And Pediatric Associates, a provider established in Holland, Michigan operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1003924739 assigned on August 2006. The practitioner's primary taxonomy code is 261QM1300X with license number 4301066494 (MI). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Barbara Martin Cpc (Billing)
- NPI
- 1003924739
- Provider Name
- LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES
- Entity Type
- Organization
- Location Address
- 437 NORTH 120TH AVE HOLLAND, MI 49424
- Location Phone
- (616) 738-0737
- Mailing Address
- 437 NORTH 120TH AVE HOLLAND, MI 49424
- Mailing Phone
- (616) 738-0737
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-25-2006
- Last Update Date
- 06-07-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
- License No.
- 4301066494
- License State
- MI
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | 4301074294 (MI) |
| 2 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | 4301074445 (MI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| G96493 | MEDICARE UPIN (02) | MI | |
| 4531728 | MEDICAID (05) | MI | |
| 4529541 | MEDICAID (05) | MI | |
| H83269 | MEDICARE UPIN (02) | MI | |
| 0N14150002 | MEDICARE ID-TYPE UNSPECIFIED (04) | MI | DR SCHROTENBOER |
| 0N14150004 | MEDICARE ID-TYPE UNSPECIFIED (04) | MI | DR MILLER |
| H64113 | MEDICARE UPIN (02) | MI | |
| 4193863 | MEDICAID (05) | MI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D0967100
- Facility Type
- Physician Office
- Certificate Effective Date
- November 03, 2023
- Certificate Expiration Date
- November 02, 2025
- Laboratory Director
- GREGORY A. SCHROTENBOER MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Lakeshore Internal Medicine And Pediatric Associates in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003924739, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003924739, enumerated as an "organization" on August 25, 2006.
The provider is located at 437 NORTH 120TH AVE HOLLAND, MI 49424 and the phone number is (616) 738-0737.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
