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LAKE SUMTER UROLOGY, LLC
NPI 1285385401
Urology in Lady Lake, FL

Active since January 11, 2022CLIA 10D2263114 · Waiver
808 HIGHWAY 466, LADY LAKE, FL 32159(352) 775-6899(877) 319-1879 Get Directions Write a Review

NPPES record last updated: November 22, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 22, 2023, Jan 11, 2022 (2 updates tracked since 2022).

About Lake Sumter Urology, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SUMTER UROLOGY, LLC (NPI 1285385401) is a healthcare organization registered as an urology in Lady Lake, Florida and active in the NPI registry since January 2022. The organization holds a CLIA Waiver certificate valid through June 22, 2028 and lists Venkata Marella, Owner And Ao, as its authorized official.

NPPES Registry Identity

NPI1285385401
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameLAKE SUMTER UROLOGY, LLC
Location Address808 HIGHWAY 466Lady Lake, FL 32159-3918
Mailing Address808 Highway 466Lady Lake, FL 32159-3918 · (352) 775-6899 · Fax (877) 319-1879
Phone(352) 775-6899
Fax(877) 319-1879
Organization SubpartNo
Authorized OfficialVenkata MarellaOwner And Ao · (352) 775-6899
Enumeration DateJanuary 11, 2022
Last NPPES UpdateNovember 22, 20232 updates tracked since enumeration
NPPES CertifiedNovember 22, 2023
✔ NPI 1285385401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
808 HIGHWAY 466, Lady Lake, FL 32159
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Sumter Urology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Lake Sumter Urology, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Rosemary Gavan, ARNP
Nurse Practitioner
NPI 1295872083
808 HIGHWAY 466
Lady Lake, FL 32159
(352) 751-0040
✔ PECOS✔ Accepts MedicareSame address
Emily Perry-Hartlein, APRN
Nurse Practitioner
NPI 1841691987
1400 N US HIGHWAY 441 STE 540
Lady Lake, FL 32159
(352) 753-9777
✔ PECOS✔ Accepts Medicare2.0 mi
Pamala Howard, APRN
Nurse Practitioner
NPI 1770164113
16890 US HIGHWAY 441
Mount Dora, FL 32757
(352) 729-2514
✔ PECOS✔ Accepts Medicare17 mi
Chace Nacke
Nurse Practitioner
NPI 1982560611
367 W OAK HILL RD
Mount Dora, FL 32757
(352) 409-7944
✔ PECOS✔ Accepts Medicare18 mi
Jennifer Nadeau, APRN
Nurse Practitioner
NPI 1346891777
1111 NE 25TH AVE STE 301
Ocala, FL 34470
(352) 351-7000
✔ PECOS✔ Accepts Medicare22 mi
Avril Dhana, ARNP
Nurse Practitioner
NPI 1720394075
11063 COUNTY LINE RD
Spring Hill, FL 34609
(352) 688-7744
✔ PECOS49 mi
Venkata Marella, MD
Urology
NPI 1083695373
1033 CLIFTON AVE
Clifton, NJ 07013
(973) 473-5700
✔ PECOS✔ Accepts Medicare934 mi

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 10D2263114

Lake Sumter Urology, LLC · Lady Lake, FL
Active · expires Jun 22, 2028
CLIA Number10D2263114
Laboratory TypePhysician Office
Certificate Effective DateJune 23, 2026
Certificate Expiration DateJune 22, 2028
Laboratory DirectorVenkata Marella
Laboratory Phone(352) 775-6899
Laboratory LocationLake Sumter Urology, LLC808 Cr 466, Lady Lake, FL 32159
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Sumter Urology, LLC's NPI number?

The NPI number for Lake Sumter Urology, LLC is 1285385401. It was assigned to this organization in the NPPES registry on January 11, 2022.

Where is Lake Sumter Urology, LLC located?

Lake Sumter Urology, LLC is located at 808 Highway 466, Lady Lake, FL 32159. The listed phone number is (352) 775-6899.

What is Lake Sumter Urology, LLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Lake Sumter Urology, LLC enrolled in Medicare?

Yes. Lake Sumter Urology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Sumter Urology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Lake Sumter Urology, LLC. 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 (6) and Urology (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lake Sumter Urology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2263114) is associated with this NPI, valid through June 22, 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 Sumter Urology, LLC was last updated on November 22, 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.