LAKE MEDICAL CENTER, INC.
NPI 1689863714
Psychiatry & Neurology - Neurology in San Marcos, CA
About Lake Medical Center, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE MEDICAL CENTER, INC. (NPI 1689863714) is a healthcare organization registered as a neurology in San Marcos, California and active in the NPI registry since October 2007. The organization lists Michael Shack, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 5
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lake Medical Center, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Lake Medical Center, Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
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 Medical Center, Inc.'s NPI number?
The NPI number for Lake Medical Center, Inc. is 1689863714. It was assigned to this organization in the NPPES registry on October 15, 2007.
Where is Lake Medical Center, Inc. located?
Lake Medical Center, Inc. is located at 1146 San Marino Dr, San Marcos, CA 92078. The listed phone number is (760) 471-2033.
What is Lake Medical Center, Inc.'s specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.
Is Lake Medical Center, Inc. enrolled in Medicare?
Yes. Lake Medical Center, Inc. is registered in the Medicare PECOS enrollment system.
When is Lake Medical Center, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Lake Medical Center, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Lake Medical Center, Inc.. 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 Chiropractic (3), Neurology (1) and Preventive Medicine (1). Of these, 1 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Lake Medical Center, Inc. was last updated on October 15, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Lake Medical Center, Inc. · NPI 1689863714
Neurology organization in San Marcos, California. Organization record, active in the CMS NPPES registry since October 15, 2007.
## Identity
- **NPI:** 1689863714 (Entity type: Organization)
- **Enumerated:** October 15, 2007
- **Primary specialty:** Psychiatry & Neurology - Neurology · taxonomy 2084N0400X
- **Organization subpart:** No
- **Authorized official:** Michael Shack, PRESIDENT
## Practice location
- **Address:** 1146 SAN MARINO DR, San Marcos, CA 92078-4649
- **Phone:** (760) 471-2033 · **Fax:** (760) 471-2083
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Chiropractic (3), Neurology (1), Preventive Medicine (1); 1 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 15, 2007
- **Other identifiers:** Medicare PIN G26382 (CA); Medicare UPIN A42992 (CA); Medicare PIN DC17616 (CA); and 2 more
---
Source: [NPI Profile](https://npiprofile.com/npi/1689863714) · Data from the CMS NPPES public registry.