RICHARD A WEBBER DBA LAKE CITY PRIMARY CARE
NPI 1164850053
Family Medicine in Plattsburgh, NY
About Richard A Webber Dba Lake City Primary Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RICHARD A WEBBER DBA LAKE CITY PRIMARY CARE (NPI 1164850053) is a healthcare organization registered as a family medicine in Plattsburgh, New York and active in the NPI registry since October 2013. The organization holds a CLIA Waiver certificate valid through July 6, 2028 and lists Kelley Brault, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Richard A Webber Dba Lake City Primary Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Richard A Webber Dba Lake City Primary Care, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
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 33D0975420
Lake City Primary Care Associates · Plattsburgh, NYFrequently 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 Lake City Primary Care PLLC's NPI number?
The NPI number for Lake City Primary Care PLLC is 1164850053. It was assigned to this organization in the NPPES registry on October 31, 2013. The provider is doing business as Richard A Webber Dba Lake City Primary Care.
Where is Lake City Primary Care PLLC located?
Lake City Primary Care PLLC is located at 16 Degrandpre Way Suite 300, Plattsburgh, NY 12901. The listed phone number is (518) 561-8256.
What is Lake City Primary Care PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Lake City Primary Care PLLC enrolled in Medicare?
Yes. Lake City Primary Care PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lake City Primary Care PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Lake City Primary Care PLLC. 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 Nurse Practitioner (5), Family Practice (2) and Internal Medicine (1). Of these, 3 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Lake City Primary Care PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D0975420) is associated with this NPI, valid through July 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Lake City Primary Care PLLC was last updated on January 17, 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.
# Richard A Webber Dba Lake City Primary Care · NPI 1164850053
Family Medicine organization in Plattsburgh, New York. Organization record, active in the CMS NPPES registry since October 31, 2013.
## Identity
- **NPI:** 1164850053 (Entity type: Organization)
- **Enumerated:** October 31, 2013
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Lake City Primary Care Pllc
- **Organization subpart:** No
- **Authorized official:** Kelley Brault, OFFICE MANAGER
## Practice location
- **Address:** 16 DEGRANDPRE WAY, SUITE 300, Plattsburgh, NY 12901-6451
- **Phone:** (518) 561-8256
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Family Practice (2), Internal Medicine (1); 3 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 17, 2014
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164850053) · Data from the CMS NPPES public registry.