LIFEGUARD MEDICAL GROUP, LLC
NPI 1548436538
Emergency Medicine in Chilmark, MA

NPI Status: Active since April 30, 2008

Contact Information

45 BLUE BARQUE RD
CHILMARK, MA
ZIP 02535
Phone: (508) 696-6863
Fax: (508) 696-6864

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  • Organization
  • Emergency Medicine
  • CLIA Number: 22D1097315
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-23-2027

About LIFEGUARD MEDICAL GROUP, LLC

This page provides the complete NPI Profile along with additional information for Lifeguard Medical Group, Llc, a provider established in Chilmark, Massachusetts operating as a Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1548436538 assigned on April 2008. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Lifeguard Medical Group, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Jeffrey R Zack Md (Manager)

NPI
1548436538
Provider Name
LIFEGUARD MEDICAL GROUP, LLC
Entity Type
Organization
Location Address
45 BLUE BARQUE RD CHILMARK, MA 02535
Location Phone
(508) 696-6863
Location Fax
(508) 696-6864
Mailing Address
PO BOX 1356 OAK BLUFFS, MA 02557
Mailing Phone
(508) 696-6863
Mailing Fax
(508) 696-6864
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-30-2008
Last Update Date
05-10-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Emergency Medicine

Taxonomy Code
207P00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. JEFFREY R ZACK MD

Authorized Official Title
MANAGER
Authorized Official Phone
(401) 419-3826

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
22D1097315
Facility Type
Physician Office
Certificate Effective Date
March 24, 2025
Certificate Expiration Date
March 23, 2027
Laboratory Director
JEFFREY ZACK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Lifeguard Medical Group, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1548436538, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
4
Doubled → 8
Pos 4
8
Unchanged
Pos 5
4
Doubled → 8
Pos 6
3
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
5
Unchanged
Pos 9
3
Doubled → 6
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 6 → 12 → 3 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 8 + 8 + 8 + 3 + 1 + 2 + 5 + 6 + 24 = 72

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1548436538.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548436538, enumerated as an "organization" on April 30, 2008.

The provider is located at 45 BLUE BARQUE RD CHILMARK, MA 02535 and the phone number is (508) 696-6863.

Emergency Medicine with taxonomy code 207P00000X.