SOUTH LAKE CLINIC, P.A.
NPI 1427027184
Pediatrics in Minnetonka, MN
About South Lake Clinic, P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH LAKE CLINIC, P.A. (NPI 1427027184), doing business as South Lake Pediatrics, is a healthcare organization registered as a pediatrics in Minnetonka, Minnesota and active in the NPI registry since March 2006. The organization lists Michael Garvis, Owner/medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
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)
South Lake Clinic, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
28Medicare enrollment records show 28 clinicians reassign Medicare billing to South Lake Clinic, P.A., which bills Medicare for the services they deliver. Of these, 17 practice at this address and 18 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 2
Nearest to this location (20)
See all 28Minnetonka, MN 55345
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 South Lake Clinic, P.A.'s NPI number?
The NPI number for South Lake Clinic, P.A. is 1427027184. It was assigned to this organization in the NPPES registry on March 15, 2006. The provider is doing business as South Lake Pediatrics.
Where is South Lake Clinic, P.A. located?
South Lake Clinic, P.A. is located at 17705 Hutchins Dr Suite 101, Minnetonka, MN 55345. The listed phone number is (952) 401-8300.
What is South Lake Clinic, P.A.'s specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is South Lake Clinic, P.A. enrolled in Medicare?
Yes. South Lake Clinic, P.A. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Lake Clinic, P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 28 clinicians in 2 Medicare specialties reassign their Medicare billing to South Lake Clinic, P.A.. 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 Pediatric Medicine (23) and Nurse Practitioner (5). Of these, 17 practice at this address and 18 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does South Lake Clinic, P.A. accept?
Health plans from HealthPartners and Medica list South Lake Clinic, P.A. 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 South Lake Clinic, P.A. was last updated on September 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 44 days 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.
# South Lake Clinic, P.a. · NPI 1427027184
Pediatrics organization in Minnetonka, Minnesota. Organization record, active in the CMS NPPES registry since March 15, 2006.
## Identity
- **NPI:** 1427027184 (Entity type: Organization)
- **Enumerated:** March 15, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Also known as:** South Lake Pediatrics (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Michael Garvis, OWNER/MEDICAL DIRECTOR
## Practice location
- **Address:** 17705 HUTCHINS DR, SUITE 101, Minnetonka, MN 55345-4145
- **Phone:** (952) 401-8300 · **Fax:** (952) 401-8243
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 28 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Pediatric Medicine (23), Nurse Practitioner (5); 17 practice at this address and 18 within 10 miles; [full list](https://npiprofile.com/npi/1427027184/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 28, 2026
- **Other identifiers:** Medicaid 091010400 (MN); Other 16623SO (MN)
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Source: [NPI Profile](https://npiprofile.com/npi/1427027184) · Data from the CMS NPPES public registry.