SOUTH LAKE PAIN INSTITUTE, INC
NPI 1033121546
Specialist in Clermont, FL
About South Lake Pain Institute, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH LAKE PAIN INSTITUTE, INC (NPI 1033121546), doing business as South Lake Pain Institute, Pa, is a healthcare organization registered as a specialist in Clermont, Florida and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through October 30, 2027 and lists Samildre Pacheco, Practice Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Lake Pain Institute, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to South Lake Pain Institute, Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D1075893
South Lake Pain Institute Inc · Clermont, FLFrequently 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 South Lake Pain Institute, Inc's NPI number?
The NPI number for South Lake Pain Institute, Inc is 1033121546. It was assigned to this organization in the NPPES registry on August 13, 2006. The provider was formerly known as South Lake Pain Institute, PA.
Where is South Lake Pain Institute, Inc located?
South Lake Pain Institute, Inc is located at 2440 Hooks Street, Clermont, FL 34711. The listed phone number is (352) 394-0833.
What is South Lake Pain Institute, Inc's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is South Lake Pain Institute, Inc enrolled in Medicare?
Yes. South Lake Pain Institute, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Lake Pain Institute, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to South Lake Pain Institute, Inc, in Anesthesiology and Interventional Pain Management. 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, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does South Lake Pain Institute, Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D1075893) is associated with this NPI, valid through October 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does South Lake Pain Institute, Inc accept?
Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list South Lake Pain Institute, Inc 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 South Lake Pain Institute, Inc was last updated on October 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# South Lake Pain Institute, Inc · NPI 1033121546
Specialist organization in Clermont, Florida. Organization record, active in the CMS NPPES registry since August 13, 2006.
## Identity
- **NPI:** 1033121546 (Entity type: Organization)
- **Enumerated:** August 13, 2006
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Also known as:** South Lake Pain Institute, Inc (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Samildre Pacheco, PRACTICE ADMINISTRATOR
## Practice location
- **Address:** 2440 HOOKS STREET, Clermont, FL 34711
- **Phone:** (352) 394-0833 · **Fax:** (352) 394-0367
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Anesthesiology (1), Interventional Pain Management (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 8, 2019
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1033121546) · Data from the CMS NPPES public registry.