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LAKESIDE ORTHOPEDIC INSTITUTE LLC
NPI 1679764229
Orthopaedic Surgery in Lake Havasu City, AZ

Active since August 08, 2007
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403(928) 505-5555 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 22, 2026, Aug 17, 2021, Jun 18, 2020 (3 updates tracked since 2020).

About Lakeside Orthopedic Institute Llc NPPES

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

LAKESIDE ORTHOPEDIC INSTITUTE LLC (NPI 1679764229) is a healthcare organization registered as an orthopaedic surgery in Lake Havasu City, Arizona and active in the NPI registry since August 2007. The organization lists Daniel Edward Heiner, Partner, as its authorized official.

NPPES Registry Identity

NPI1679764229
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameLAKESIDE ORTHOPEDIC INSTITUTE LLC
Location Address25 RIVIERA BLVDLake Havasu City, AZ 86403-5694
Mailing Address25 Riviera BlvdLake Havasu City, AZ 86403-5694 · (928) 505-5555
Phone(928) 505-5555
Organization SubpartNo
Authorized OfficialDaniel Edward HeinerPartner · (928) 505-5555
Enumeration DateAugust 8, 2007
Last NPPES UpdateApril 22, 20263 updates tracked since enumeration
NPPES CertifiedApril 22, 2026
✔ NPI 1679764229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedPain Medicine · Interventional Pain MedicineTaxonomy 208VP0014X
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedRadiologic Technologist · Magnetic Resonance ImagingTaxonomy 2471M1202X
25 RIVIERA BLVD, Lake Havasu City, AZ 86403
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Other Identifiers 1

OtherDF0357AZ · Medicare Railroad

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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 Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.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)

Lakeside Orthopedic Institute Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

13

Medicare enrollment records show 13 clinicians reassign Medicare billing to Lakeside Orthopedic Institute LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 8 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 7

Physical Therapist in Private Practice4
Orthopedic Surgery3
Nurse Practitioner2
Anesthesiology1
Interventional Pain Management1
Pain Management1
Podiatry1

Clinicians, nearest first (13)

Daniel Heiner, MD
Orthopedic Surgery
NPI 1841270873
25 RIVIERA BLVD
Lake Havasu City, AZ 86403
(928) 505-5555
✔ PECOS✔ Accepts MedicareSame address
Ronald Killian, DPM
Podiatry
NPI 1205813565
25 RIVIERA BLVD
Lake Havasu City, AZ 86403
(928) 505-5555
✔ PECOS✔ Accepts MedicareSame address
Selaiman Noori, MD
Anesthesiology
NPI 1104244631
25 RIVIERA BLVD
Lake Havasu City, AZ 86403
(928) 505-7246
✔ PECOS✔ Accepts MedicareSame address
Brittany Woodall, DO
Orthopedic Surgery
NPI 1861846867
25 RIVIERA BLVD
Lake Havasu City, AZ 86403
(928) 505-5555
✔ PECOS✔ Accepts MedicareSame address
Jack Diep, MD
Pain Management
NPI 1912333014
1791 MESQUITE AVE
Lake Havasu City, AZ 86403
(928) 505-5555
✔ PECOS✔ Accepts Medicare0.2 mi
Ryan Hopp, DPT
Physical Therapist in Private Practice
NPI 1447069059
1791 MESQUITE AVE
Lake Havasu City, AZ 86403
(928) 855-4248
✔ Accepts Medicare0.2 mi
Thomas White
Physical Therapist in Private Practice
NPI 1720644537
1791 MESQUITE AVE
Lake Havasu City, AZ 86403
(610) 401-1926
✔ Accepts Medicare0.2 mi
Shawn O'haver, AG-ACNP
Nurse Practitioner
NPI 1922450493
84 ACOMA BLVD N STE 106
Lake Havasu City, AZ 86403
(928) 412-8808
✔ PECOS✔ Accepts Medicare0.7 mi
Jason Vincent, NP
Nurse Practitioner
NPI 1912504812
7201 W CAMINO SAN XAVIER
Glendale, AZ 85308
(480) 985-1093
✔ PECOS✔ Accepts Medicare135 mi
Kishore Tipirneni, M.D.
Orthopedic Surgery
NPI 1033184486
19636 N 27TH AVE STE 401
Phoenix, AZ 85027
(602) 298-8888
✔ PECOS✔ Accepts Medicare139 mi
Barry Wood, RPT
Physical Therapist in Private Practice
NPI 1346508983
900 E WASHINGTON ST STE. 100
Colton, CA 92324
(909) 433-3200
✔ Accepts Medicare173 mi
Greyson Winiger, DPT
Physical Therapist in Private Practice
NPI 1386381820
10027 W REMINGTON AVE
Littleton, CO 80127
(720) 922-7553
✔ Accepts Medicare619 mi
Gerard Myers, DO
Interventional Pain Management
NPI 1740235944
3627 BRODHEAD RD SUITE 1
Monaca, PA 15061
(724) 728-7880
✔ PECOS✔ Accepts Medicare1,903 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 Lakeside Orthopedic Institute LLC's NPI number?

The NPI number for Lakeside Orthopedic Institute LLC is 1679764229. It was assigned to this organization in the NPPES registry on August 8, 2007.

Where is Lakeside Orthopedic Institute LLC located?

Lakeside Orthopedic Institute LLC is located at 25 Riviera Blvd, Lake Havasu City, AZ 86403. The listed phone number is (928) 505-5555.

What is Lakeside Orthopedic Institute LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Lakeside Orthopedic Institute LLC enrolled in Medicare?

Yes. Lakeside Orthopedic Institute LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lakeside Orthopedic Institute LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 7 Medicare specialties reassign their Medicare billing to Lakeside Orthopedic Institute LLC. 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 Physical Therapist in Private Practice (4), Orthopedic Surgery (3) and Nurse Practitioner (2). Of these, 4 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lakeside Orthopedic Institute LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 20 other insurers list Lakeside Orthopedic Institute LLC 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 Lakeside Orthopedic Institute LLC was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.