LAKE RHEUMATOLOGY
NPI 1295916476
Internal Medicine - Rheumatology in Tavares, FL
About Lake Rheumatology NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE RHEUMATOLOGY (NPI 1295916476), doing business as Kenneth E Stark Md Pa, is a healthcare organization registered as a rheumatology in Tavares, Florida and active in the NPI registry since November 2007. The organization lists Selina De Leon Bowers, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
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 Rheumatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Lake Rheumatology, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
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 Rheumatology's NPI number?
The NPI number for Lake Rheumatology is 1295916476. It was assigned to this organization in the NPPES registry on November 16, 2007. The provider was formerly known as Kenneth E Stark MD PA.
Where is Lake Rheumatology located?
Lake Rheumatology is located at 1613 Banning Beach Road, Tavares, FL 32778. The listed phone number is (352) 343-7735.
What is Lake Rheumatology's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.
Is Lake Rheumatology enrolled in Medicare?
Yes. Lake Rheumatology is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lake Rheumatology?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Lake Rheumatology, in Nurse Practitioner and Rheumatology. 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 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Lake Rheumatology accept?
Health plans from Florida Blue (BlueCross BlueShield FL) list Lake Rheumatology 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 Rheumatology was last updated on August 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 Rheumatology · NPI 1295916476
Rheumatology organization in Tavares, Florida. Organization record, active in the CMS NPPES registry since November 16, 2007.
## Identity
- **NPI:** 1295916476 (Entity type: Organization)
- **Enumerated:** November 16, 2007
- **Primary specialty:** Internal Medicine - Rheumatology · taxonomy 207RR0500X
- **Also known as:** Kenneth E Stark MD PA (Former Legal Business Name)
- **Organization subpart:** No
- **Authorized official:** Selina De Leon Bowers, OWNER
## Practice location
- **Address:** 1613 BANNING BEACH ROAD, Tavares, FL 32778
- **Phone:** (352) 343-7735 · **Fax:** (352) 343-7740
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Rheumatology (2); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 7, 2026
- **Other identifiers:** Other 09127 (FL); Medicaid 370164600 (FL); Other 6515425 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1295916476) · Data from the CMS NPPES public registry.