EAST LAKE MEDICAL, PLLC
NPI 1497494777
Nurse Practitioner in Tyler, TX
About East Lake Medical, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST LAKE MEDICAL, PLLC (NPI 1497494777) is a healthcare organization registered as a nurse practitioner in Tyler, Texas and active in the NPI registry since June 2022. The organization holds a CLIA Waiver certificate valid through June 6, 2028 and lists Jena Decanter, Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Group Practice 1
Accepted Insurance
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 45D2261871
East Lake Medical, PLLC · Tyler, TXOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 East Lake Medical, PLLC's NPI number?
The NPI number for East Lake Medical, PLLC is 1497494777. It was assigned to this organization in the NPPES registry on June 3, 2022.
Where is East Lake Medical, PLLC located?
East Lake Medical, PLLC is located at 11980 State Highway 64 E Ste G, Tyler, TX 75707. The listed phone number is (903) 650-8619.
What is East Lake Medical, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Does East Lake Medical, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2261871) is associated with this NPI, valid through June 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does East Lake Medical, PLLC accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list East Lake Medical, PLLC 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 East Lake Medical, PLLC was last updated on June 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.
