LAKE SHORE RETINA, S.C. CORP
NPI 1255564258
Ophthalmology in Dandridge, TN
About Lake Shore Retina, S.c. Corp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE SHORE RETINA, S.C. CORP (NPI 1255564258) is a healthcare organization registered as an ophthalmology in Dandridge, Tennessee and active in the NPI registry since August 2009. The organization lists Srilakshmi Maguluri, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Lake Shore Retina, S.c. Corp 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 Lake Shore Retina, S.C. Corp, which bills Medicare for the services they deliver. 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.
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 Lake Shore Retina, S.C. Corp's NPI number?
The NPI number for Lake Shore Retina, S.C. Corp is 1255564258. It was assigned to this organization in the NPPES registry on August 25, 2009.
Where is Lake Shore Retina, S.C. Corp located?
Lake Shore Retina, S.C. Corp is located at 1208 Gay St, Dandridge, TN 37725. The listed phone number is (865) 484-9948.
What is Lake Shore Retina, S.C. Corp's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Lake Shore Retina, S.C. Corp enrolled in Medicare?
Yes. Lake Shore Retina, S.C. Corp is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lake Shore Retina, S.C. Corp?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Ophthalmology, reassign their Medicare billing to Lake Shore Retina, S.C. Corp. 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.
What insurance does Lake Shore Retina, S.C. Corp accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Lake Shore Retina, S.C. Corp 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 Lake Shore Retina, S.C. Corp was last updated on January 10, 2024. 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.
# Lake Shore Retina, S.c. Corp · NPI 1255564258
Ophthalmology organization in Dandridge, Tennessee. Organization record, active in the CMS NPPES registry since August 25, 2009.
## Identity
- **NPI:** 1255564258 (Entity type: Organization)
- **Enumerated:** August 25, 2009
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **Organization subpart:** No
- **Authorized official:** Srilakshmi Maguluri, PRESIDENT
## Practice location
- **Address:** 1208 GAY ST, Dandridge, TN 37725-4720
- **Phone:** (865) 484-9948
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Ophthalmology) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 10, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1255564258) · Data from the CMS NPPES public registry.