PRIMEHEALTH SURGERY
NPI 1508800426
Surgery in Willoughby, OH

Q: What is Lake Hospital System Inc's NPI number?

The NPI number for Lake Hospital System Inc is 1508800426. It was assigned to this organization in the NPPES registry on June 15, 2006. The provider is doing business as Primehealth Surgery.

Q: What is Lake Hospital System Inc's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since June 15, 2006

36060 EUCLID AVE, SUITE 204, WILLOUGHBY, OH 44094(440) 602-6553(440) 602-6566 Get Directions Write a Review

NPPES record last updated: September 10, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Primehealth Surgery NPPES

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

PRIMEHEALTH SURGERY (NPI 1508800426) is a healthcare organization registered as a surgery in Willoughby, Ohio and active in the NPI registry since June 2006. The organization lists Robert Tracz, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1508800426

Entity TypeOrganization

Primary Taxonomy208600000X

Legal Business NameLAKE HOSPITAL SYSTEM INC

Location Address36060 EUCLID AVE, SUITE 204Willoughby, OH 44094-4656

Mailing AddressPo Box 714328Columbus, OH 73271-4328 · (800) 354-1985 · Fax (440) 350-4938

Phone(440) 602-6553

Fax(440) 602-6566

Organization SubpartYesParent: Lake Hospital System, Inc.

Authorized OfficialRobert TraczChief Financial Officer · (440) 354-1051

Enumeration DateJune 15, 2006

Last NPPES UpdateSeptember 10, 2007

✔ NPI 1508800426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

36060 EUCLID AVE, Willoughby, OH 44094

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Other Names 1

Doing Business AsPrimehealth Surgery

Other Identifiers 2

Medicare PINLA9368241OH

Medicaid2591502OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Primehealth Surgery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

284

Medicare enrollment records show 284 clinicians reassign Medicare billing to Primehealth Surgery, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 147 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 29

Nurse Practitioner115

Family Practice51

Internal Medicine20

Obstetrics/Gynecology16

Neurology12

General Surgery10

Pediatric Medicine10

Cardiovascular Disease (Cardiology)7

21 other specialties43

Nearest to this location (20)

See all 284

Sherry Clemente, CNP

Nurse Practitioner

NPI 1528494531

36060 EUCLID AVE SUITE 204
Willoughby, OH 44094

(440) 602-6553

✔ PECOS✔ Accepts MedicareSame address

Patrick Convery, MD

Orthopedic Surgery

NPI 1437230307

36060 EUCLID AVE STE 203
Willoughby, OH 44094

(440) 602-6670

✔ PECOS✔ Accepts MedicareSame address

Jeffrey Jordan, NP-C

Nurse Practitioner

NPI 1770890055

36060 EUCLID AVE STE 107
Willoughby, OH 44094

(440) 375-8100

✔ PECOS✔ Accepts MedicareSame address

Diana Mackensen, FNP-C

Nurse Practitioner

NPI 1629575329

36060 EUCLID AVE
Willoughby, OH 44094

(440) 953-9600

✔ PECOS✔ Accepts MedicareSame address

William Petraiuolo, MD

General Surgery

NPI 1144336470

36060 EUCLID AVE SUITE 204
Willoughby, OH 44094

(440) 602-6553

✔ PECOSSame address

April Debiasi, NP-C

Nurse Practitioner

NPI 1093273138

35900 EUCLID AVE
Willoughby, OH 44094

(440) 812-0868

✔ PECOS✔ Accepts Medicare0.1 mi

Karamjit Kaur

Nurse Practitioner

NPI 1235975947

36000 EUCLID AVE
Willoughby, OH 44094

(440) 953-9600

✔ PECOS✔ Accepts Medicare0.1 mi

Iola Pustelnick, C.N.M.

Certified Nurse Midwife (CNM)

NPI 1275566556

36001 EUCLID AVE STE C7
Willoughby, OH 44094

(440) 602-6710

✔ PECOS✔ Accepts Medicare0.1 mi

Martin Mandel, M.D.

Endocrinology

NPI 1649238395

36100 EUCLID AVE SUITE 320
Willoughby, OH 44094

(440) 951-1073

✔ PECOS0.1 mi

Laura Bailey, MD

Internal Medicine

NPI 1770699019

36100 EUCLID AVE #240
Willoughby, OH 44094

(440) 953-6294

✔ PECOS✔ Accepts Medicare0.1 mi

Aviv Ben Meir, M.D.

General Surgery

NPI 1417028556

36100 EUCLID AVE STE 170
Willoughby, OH 44094

(440) 602-6737

✔ PECOS0.1 mi

Christopher Daugherty, M.D.

Ophthalmology

NPI 1770926818

36100 EUCLID AVE STE 450
Willoughby, OH 44094

(440) 946-9555

✔ PECOS✔ Accepts Medicare0.1 mi

Timothy Doyle, MD

Cardiovascular Disease (Cardiology)

NPI 1861451403

36100 EUCLID AVE SUITE 120
Willoughby, OH 44094

(440) 951-8360

✔ PECOS0.1 mi

Dennis Jurcevic, M.D.

Sleep Medicine

NPI 1780847632

36100 EUCLID AVE SUITE 210
Willoughby, OH 44094

(440) 602-6770

✔ PECOS✔ Accepts Medicare0.1 mi

Sandeep Kotak, MD

Internal Medicine

NPI 1013023357

36100 EUCLID AVE STE 240
Willoughby, OH 44094

(440) 953-6294

✔ PECOS✔ Accepts Medicare0.1 mi

Rebecca Crockett, DO

Obstetrics/Gynecology

NPI 1376702241

5105 SOM CENTER ROAD SUITE 201
Willoughby, OH 44094

(440) 602-6710

✔ PECOS✔ Accepts Medicare0.5 mi

Gary Kammer, M.D.

Rheumatology

NPI 1083685952

5105 SOM CENTER RD # 105
Willoughby, OH 44094

(440) 953-8700

✔ PECOS0.5 mi

Patrick Mcintyre, MD

Pain Management

NPI 1831142140

5105 SOM CENTER ROAD SUITE 202
Willoughby, OH 44094

(440) 953-5760

✔ PECOS✔ Accepts Medicare0.5 mi

Tam Mclean

Family Practice

NPI 1114260122

5105 SOM CENTER RD #106
Willoughby, OH 44094

(440) 953-5740

✔ PECOS✔ Accepts Medicare0.5 mi

Henry Vucetic, MD

Anesthesiology

NPI 1104015213

5105 SOM CENTER ROAD SUITE 202
Willoughby, OH 44094

(440) 953-5760

✔ PECOS0.5 mi

See all 284 clinicians

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 Hospital System Inc's NPI number?

The NPI number for Lake Hospital System Inc is 1508800426. It was assigned to this organization in the NPPES registry on June 15, 2006. The provider is doing business as Primehealth Surgery.

Where is Lake Hospital System Inc located?

Lake Hospital System Inc is located at 36060 Euclid Ave Suite 204, Willoughby, OH 44094. The listed phone number is (440) 602-6553.

What is Lake Hospital System Inc's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Lake Hospital System Inc enrolled in Medicare?

Yes. Lake Hospital System Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Hospital System Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 284 clinicians in 29 Medicare specialties reassign their Medicare billing to Lake Hospital System Inc. 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 Nurse Practitioner (115), Family Practice (51) and Internal Medicine (20). Of these, 5 practice at this address and 147 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lake Hospital System Inc was last updated on September 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.