LAKESIDE ORTHOPEDIC INSTITUTE, LLC
NPI 1356099790
Family Medicine in Lake Havasu City, AZ
About Lakeside Orthopedic Institute, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE ORTHOPEDIC INSTITUTE, LLC (NPI 1356099790), doing business as Lakeside Primary Care, is a healthcare organization registered as a family medicine in Lake Havasu City, Arizona and active in the NPI registry since March 2022. The organization maintains a secondary practice location in Lake Havasu City and lists Daniel Edward Heiner, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 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)
Lakeside Orthopedic Institute, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Lakeside Orthopedic Institute, LLC, which bills Medicare for the services they deliver. Of these, 8 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 7
Clinicians, nearest first (13)
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 Orthopedic Institute, LLC's NPI number?
The NPI number for Lakeside Orthopedic Institute, LLC is 1356099790. It was assigned to this organization in the NPPES registry on March 15, 2022. The provider is doing business as Lakeside Primary Care.
Where is Lakeside Orthopedic Institute, LLC located?
Lakeside Orthopedic Institute, LLC is located at 1720 Mesquite Ave Ste 100, Lake Havasu City, AZ 86403. The listed phone number is (928) 505-5555.
What is Lakeside Orthopedic Institute, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Lakeside Orthopedic Institute, LLC enrolled in Medicare?
Yes. Lakeside Orthopedic Institute, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lakeside Orthopedic Institute, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 7 Medicare specialties reassign their Medicare billing to Lakeside Orthopedic Institute, 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 Physical Therapist in Private Practice (4), Orthopedic Surgery (3) and Nurse Practitioner (2). Of these, 8 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Lakeside Orthopedic Institute, LLC accept?
Health plans from Baylor Scott and White Health Plan, Blue Cross Blue Shield of North Dakota, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Lakeside Orthopedic Institute, LLC 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 Lakeside Orthopedic Institute, LLC was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Lakeside Orthopedic Institute, Llc · NPI 1356099790
Family Medicine organization in Lake Havasu City, Arizona. Organization record, active in the CMS NPPES registry since March 15, 2022.
## Identity
- **NPI:** 1356099790 (Entity type: Organization)
- **Enumerated:** March 15, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Lakeside Primary Care (Doing Business As)
- **Organization subpart:** Yes (part of Lakeside Orthopedic Institute, Llc)
- **Authorized official:** Daniel Heiner, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 1720 MESQUITE AVE STE 100, Lake Havasu City, AZ 86403-5602
- **Phone:** (928) 505-5555 · **Fax:** (928) 505-5557
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 13 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Physical Therapist in Private Practice (4), Orthopedic Surgery (3), Nurse Practitioner (2); 8 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 22, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1356099790) · Data from the CMS NPPES public registry.