LAKE INTERNAL MEDICINE ASSOCIATES
NPI 1679595649
Nurse Practitioner - Family in Eustis, FL

NPI Status: Active since July 25, 2006

Contact Information

2101 PREVATT ST
EUSTIS, FL
ZIP 32726
Phone: (352) 589-4774
Fax: (352) 589-5092

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  • Organization
  • Nurse Practitioner
  • Family
  • Accepts Insurance
  • CLIA Number: 10D0681600
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-20-2026

About LAKE INTERNAL MEDICINE ASSOCIATES

This page provides the complete NPI Profile along with additional information for Lake Internal Medicine Associates, a provider established in Eustis, Florida operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1679595649 assigned on July 2006. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Bonnie L Demuth (Practice Manager)

NPI
1679595649
Provider Name
LAKE INTERNAL MEDICINE ASSOCIATES
Entity Type
Organization
Location Address
2101 PREVATT ST EUSTIS, FL 32726
Location Phone
(352) 589-4774
Location Fax
(352) 589-5092
Mailing Address
2101 PREVATT ST EUSTIS, FL 32726
Mailing Phone
(352) 589-4774
Mailing Fax
(352) 589-5092
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-25-2006
Last Update Date
09-19-2024
Code Navigator

A nurse practitioner (NP) like Lake Internal Medicine Associates is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

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

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 (Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
  • BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
  • BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
  • BlueSelect Bronze 1449 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - EPO
  • BlueSelect Bronze 2139 ($50 PCP Visits / Rewards) - EPO
  • BlueSelect Bronze 2139E ($50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
  • BlueSelect Bronze 2139V ($50 PCP Visits / Adult Vision / Rewards) - EPO
  • BlueSelect Bronze 2342S ($50 PCP Visits / Rewards) - EPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-05 (Rewards) - POS
  • BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-18 (Rewards) - POS
  • BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
  • BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
  • BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
  • BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

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

BONNIE L DEMUTH

Authorized Official Title
PRACTICE MANAGER
Authorized Official Phone
(352) 589-4774

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
10D0681600
Facility Type
Physician Office
Certificate Effective Date
December 21, 2024
Certificate Expiration Date
December 20, 2026
Laboratory Director
STEVEN M. TANG
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Lake Internal Medicine Associates 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 1679595649, we treat the final digit (9) 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 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).

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
6
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
9
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
9
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
6
Unchanged
Pos 9
4
Doubled → 8
Check
9
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 7 → 14 → 5 5 → 10 → 1 5 → 10 → 1 4 → 8

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 1 + 4 + 9 + 1 + 0 + 9 + 1 + 0 + 6 + 8 + 24 = 71

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

The next multiple of ten after 71 is 80. The difference is the calculated check digit.

80 - 71 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1679595649.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
2101 PREVATT ST
EUSTIS, FL 32726
Nurse Practitioner (Family)
2101 PREVATT ST
EUSTIS, FL 32726
Nurse Practitioner (Family)
2101 PREVATT ST
EUSTIS, FL 32726

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679595649, enumerated as an "organization" on July 25, 2006.

The provider is located at 2101 PREVATT ST EUSTIS, FL 32726 and the phone number is (352) 589-4774.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL) and Florida. Please consult your insurance carrier or call the provider to verify.