LAKESIDE PODIATRY, PLLC
NPI 1174396089
Podiatrist in Victor, NY
About Lakeside Podiatry, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE PODIATRY, PLLC (NPI 1174396089) is a healthcare organization registered as a podiatrist in Victor, New York and active in the NPI registry since November 2023. The organization lists Brian Haselsberger, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Lakeside Podiatry, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Lakeside Podiatry, PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Lakeside Podiatry, PLLC's NPI number?
The NPI number for Lakeside Podiatry, PLLC is 1174396089. It was assigned to this organization in the NPPES registry on November 2, 2023.
Where is Lakeside Podiatry, PLLC located?
Lakeside Podiatry, PLLC is located at 50 Square Dr Ste 1000, Victor, NY 14564. The listed phone number is (585) 433-5040.
What is Lakeside Podiatry, PLLC's specialty?
The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.
Is Lakeside Podiatry, PLLC enrolled in Medicare?
Yes. Lakeside Podiatry, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lakeside Podiatry, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Lakeside Podiatry, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Lakeside Podiatry, PLLC was last updated on November 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 Podiatry, Pllc · NPI 1174396089
Podiatrist organization in Victor, New York. Organization record, active in the CMS NPPES registry since November 2, 2023.
## Identity
- **NPI:** 1174396089 (Entity type: Organization)
- **Enumerated:** November 2, 2023
- **Primary specialty:** Podiatrist · taxonomy 213E00000X
- **Organization subpart:** No
- **Authorized official:** Brian Haselsberger, OWNER
## Practice location
- **Address:** 50 SQUARE DR STE 1000, Victor, NY 14564-1062
- **Phone:** (585) 433-5040 · **Fax:** (585) 433-5046
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Podiatry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 2, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1174396089) · Data from the CMS NPPES public registry.