LAKESIDE FAMILY MEDICINE
NPI 1720514029
Clinic/Center - Primary Care in Gainesville, GA
About Lakeside Family Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE FAMILY MEDICINE (NPI 1720514029) is a healthcare organization registered as a primary care in Gainesville, Georgia and active in the NPI registry since May 2017. The organization lists Foroogh Narmani-mohammadi, Family Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Lakeside Family Medicine, which bills Medicare for the services this clinician delivers.
Clinician (1)
Gainesville, GA 30504
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 Family Medicine's NPI number?
The NPI number for Lakeside Family Medicine is 1720514029. It was assigned to this organization in the NPPES registry on May 4, 2017.
Where is Lakeside Family Medicine located?
Lakeside Family Medicine is located at 104 Carrington Park Dr Ste B, Gainesville, GA 30504. The listed phone number is (770) 899-3773.
What is Lakeside Family Medicine's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Lakeside Family Medicine enrolled in Medicare?
Yes. Lakeside Family Medicine is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lakeside Family Medicine?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Lakeside Family Medicine. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Lakeside Family Medicine was last updated on May 4, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Lakeside Family Medicine · NPI 1720514029
Primary Care organization in Gainesville, Georgia. Organization record, active in the CMS NPPES registry since May 4, 2017.
## Identity
- **NPI:** 1720514029 (Entity type: Organization)
- **Enumerated:** May 4, 2017
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Foroogh Narmani-Mohammadi, FAMILY NURSE PRACTITIONER
## Practice location
- **Address:** 104 CARRINGTON PARK DR STE B, Gainesville, GA 30504-6603
- **Phone:** (770) 899-3773
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 4, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1720514029) · Data from the CMS NPPES public registry.