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POLARIS MEDICAL GROUP PA
NPI 1386492726
Nurse Practitioner - Family in Lakeland, FL

Active since May 10, 2024CLIA 10D2311454 · Waiver
1705 LAKELAND HILLS BLVD STE 1, LAKELAND, FL 33805(863) 688-6051(938) 336-2587 Get Directions Write a Review

NPPES record last updated: May 10, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Polaris Medical Group Pa NPPES

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

POLARIS MEDICAL GROUP PA (NPI 1386492726) is a healthcare organization registered as a family in Lakeland, Florida and active in the NPI registry since May 2024. The organization holds a CLIA Waiver certificate valid through September 22, 2026 and lists Jaison Joseph Luke, Vice President, as its authorized official.

NPPES Registry Identity

NPI1386492726
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePOLARIS MEDICAL GROUP PA
Location Address1705 LAKELAND HILLS BLVD STE 1Lakeland, FL 33805-3061
Mailing Address1705 Lakeland Hills Blvd Ste 1Lakeland, FL 33805-3061 · (863) 688-6051 · Fax (938) 336-2587
Phone(863) 688-6051
Fax(938) 336-2587
Organization SubpartNo
Authorized OfficialJaison Joseph LukeVice President · (407) 729-4298
Enumeration DateMay 10, 2024
NPPES CertifiedMay 9, 2024
✔ NPI 1386492726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
1705 LAKELAND HILLS BLVD STE 1, Lakeland, FL 33805
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 10D2311454

Polaris Medical Group PA · Lakeland, FL
Active · expires Sep 22, 2026
CLIA Number10D2311454
Laboratory TypePhysician Office
Certificate Effective DateSeptember 23, 2024
Certificate Expiration DateSeptember 22, 2026
Laboratory DirectorJaison Joseph Luke
Laboratory Phone(863) 688-6051
Laboratory LocationPolaris Medical Group PA1705 Lakeland Hills Blvd Ste 1, Lakeland, FL 33805
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAISON JOSEPH LUKE ARNP
Nurse Practitioner (Family)
1705 LAKELAND HILLS BLVD STE 1
LAKELAND, FL 33805
Polk County (863) 688-6051

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 Polaris Medical Group PA's NPI number?

The NPI number for Polaris Medical Group PA is 1386492726. It was assigned to this organization in the NPPES registry on May 10, 2024.

Where is Polaris Medical Group PA located?

Polaris Medical Group PA is located at 1705 Lakeland Hills Blvd Ste 1, Lakeland, FL 33805. The listed phone number is (863) 688-6051.

What is Polaris Medical Group PA's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Polaris Medical Group PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2311454) is associated with this NPI, valid through September 22, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Polaris Medical Group PA was last updated on May 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.