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LAKE EAR, NOSE THROAT AND FACIAL PLASTIC SURGERY ASSOCIATES
NPI 1629091996
Specialist in Leesburg, FL

Active since July 26, 2006
601 E DIXIE AVE, PLAZA 901, LEESBURG, FL 34748(352) 728-2404(352) 787-7401 Get Directions Write a Review

NPPES record last updated: October 2, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Lake Ear, Nose Throat And Facial Plastic Surgery Associates NPPES

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

LAKE EAR, NOSE THROAT AND FACIAL PLASTIC SURGERY ASSOCIATES (NPI 1629091996) is a healthcare organization registered as a specialist in Leesburg, Florida and active in the NPI registry since July 2006. The organization lists Judith C Milstead, President, as its authorized official.

NPPES Registry Identity

NPI1629091996
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameLAKE ENT & FPS, PA
Location Address601 E DIXIE AVE, PLAZA 901Leesburg, FL 34748-5953
Mailing Address601 E Dixie Ave, Plaza 901Leesburg, FL 34748-5953 · (352) 728-2404 · Fax (352) 787-7401
Phone(352) 728-2404
Fax(352) 787-7401
Organization SubpartNo
Authorized OfficialJudith C MilsteadPresident · (352) 728-2404
Enumeration DateJuly 26, 2006
Last NPPES UpdateOctober 2, 2020
NPPES CertifiedOctober 2, 2020
✔ NPI 1629091996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
601 E DIXIE AVE, Leesburg, FL 34748
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Other Names 1

Doing Business AsLake Ear, Nose Throat And Facial Plastic Surgery Associates

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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)

Lake Ear, Nose Throat And Facial Plastic Surgery Associates is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to Lake Ear, Nose Throat And Facial Plastic Surgery Associates, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 11 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Otolaryngology5
Nurse Practitioner4
Pathology1
Qualified Audiologist1

Clinicians, nearest first (11)

Paige Holt, AUD
Qualified Audiologist
NPI 1275729543
601 E DIXIE AVE PLAZA 901
Leesburg, FL 34748
(352) 728-2404
Same address
Dino Madonna, M.D
Otolaryngology
NPI 1780684399
601 E DIXIE AVE MEDICAL PLAZA 901
Leesburg, FL 34748
(352) 728-2404
✔ PECOS✔ Accepts MedicareSame address
Judith Milstead, M.D.
Otolaryngology
NPI 1124028618
601 E DIXIE AVE MEDICAL PLAZA 901
Leesburg, FL 34748
(352) 728-2404
✔ PECOS✔ Accepts MedicareSame address
Jennifer Pollard, APRN
Nurse Practitioner
NPI 1144793472
601 E DIXIE AVE STE 901
Leesburg, FL 34748
(352) 728-2404
✔ PECOS✔ Accepts MedicareSame address
Sammy Vaught, M.D.
Otolaryngology
NPI 1619977220
601 E DIXIE AVE MEDICAL PLAZA 901
Leesburg, FL 34748
(352) 728-2404
✔ PECOS✔ Accepts MedicareSame address
Blake Gelb
Nurse Practitioner
NPI 1497472781
601 E DIXIE AVE STE 901
Leesburg, FL 34748
(352) 728-2404
✔ PECOS✔ Accepts MedicareSame address
Jeffrey Brink, M.D.
Otolaryngology
NPI 1942206206
601 E DIXIE AVE STE 901
Leesburg, FL 34748
(352) 728-2404
✔ PECOS✔ Accepts Medicare0.5 mi
Rannie Mccalla
Nurse Practitioner
NPI 1740037175
601 E DIXIE AVE PLAZA 901
Leesburg, FL 34748
(352) 728-2404
✔ PECOS✔ Accepts Medicare0.5 mi
James Allen, MD
Pathology
NPI 1073592812
120 E NORTH BLVD SUITE 102
Leesburg, FL 34748
(352) 460-0292
✔ PECOS✔ Accepts Medicare0.7 mi
Lacey Myers, APRN
Nurse Practitioner
NPI 1063001832
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts Medicare5.7 mi
Joseph Moak, M.D.
Otolaryngology
NPI 1164867644
1819 SALK AVE
Tavares, FL 32778
(352) 343-7279
✔ PECOS✔ Accepts Medicare10.0 mi

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 Ent & Fps, PA's NPI number?

The NPI number for Lake Ent & Fps, PA is 1629091996. It was assigned to this organization in the NPPES registry on July 26, 2006. The provider is doing business as Lake Ear, Nose Throat And Facial Plastic Surgery Associates.

Where is Lake Ent & Fps, PA located?

Lake Ent & Fps, PA is located at 601 E Dixie Ave Plaza 901, Leesburg, FL 34748. The listed phone number is (352) 728-2404.

What is Lake Ent & Fps, PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Lake Ent & Fps, PA enrolled in Medicare?

Yes. Lake Ent & Fps, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Ent & Fps, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 4 Medicare specialties reassign their Medicare billing to Lake Ent & Fps, PA. 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 Otolaryngology (5), Nurse Practitioner (4) and Pathology (1). Of these, 6 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lake Ent & Fps, PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Lake Ent & Fps, PA 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 Lake Ent & Fps, PA was last updated on October 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.