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

Active since April 30, 2008CLIA 22D1097315 · Waiver
45 BLUE BARQUE RD, CHILMARK, MA 02535(508) 696-6863(508) 696-6864 Get Directions Write a Review

NPPES record last updated: May 10, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lifeguard Medical Group, Llc NPPES

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

LIFEGUARD MEDICAL GROUP, LLC (NPI 1548436538) is a healthcare organization registered as an emergency medicine in Chilmark, Massachusetts and active in the NPI registry since April 2008. The organization holds a CLIA Waiver certificate valid through March 23, 2027 and lists Jeffrey R Zack, Manager, as its authorized official.

NPPES Registry Identity

NPI1548436538
Entity TypeOrganization
Primary Taxonomy207P00000X
Legal Business NameLIFEGUARD MEDICAL GROUP, LLC
Location Address45 BLUE BARQUE RDChilmark, MA 02535-2706
Mailing AddressPo Box 1356Oak Bluffs, MA 02557-1356 · (508) 696-6863 · Fax (508) 696-6864
Phone(508) 696-6863
Fax(508) 696-6864
Organization SubpartNo
Authorized OfficialJeffrey R ZackManager · (401) 419-3826
Enumeration DateApril 30, 2008
Last NPPES UpdateMay 10, 2022
NPPES CertifiedMay 10, 2022
✔ NPI 1548436538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Definition
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.
45 BLUE BARQUE RD, Chilmark, MA 02535
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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 22D1097315

Lifeguard Medical Group · Oak Bluffs, MA
Active · expires Mar 23, 2027
CLIA Number22D1097315
Laboratory TypePhysician Office
Certificate Effective DateMarch 24, 2025
Certificate Expiration DateMarch 23, 2027
Laboratory DirectorJeffrey Zack
Laboratory Phone(508) 696-6863
Laboratory LocationLifeguard Medical Group72 Eastville Avenue, Oak Bluffs, MA 02557
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Lifeguard Medical Group, LLC's NPI number?

The NPI number for Lifeguard Medical Group, LLC is 1548436538. It was assigned to this organization in the NPPES registry on April 30, 2008.

Where is Lifeguard Medical Group, LLC located?

Lifeguard Medical Group, LLC is located at 45 Blue Barque Rd, Chilmark, MA 02535. The listed phone number is (508) 696-6863.

What is Lifeguard Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Does Lifeguard Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D1097315) is associated with this NPI, valid through March 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lifeguard Medical Group, LLC was last updated on May 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.