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LAKESIDE HEART AND VASCULAR CENTER PLLC
NPI 1801194352
Internal Medicine - Interventional Cardiology in Lake Havasu City, AZ

Active since March 08, 2011CLIA Certified · 2 labs
1741 MESQUITE AVE, SUITE A100, LAKE HAVASU CITY, AZ 86403(928) 453-2727(928) 453-2828 Get Directions Write a Review

NPPES record last updated: July 20, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Lakeside Heart And Vascular Center Pllc NPPES

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

LAKESIDE HEART AND VASCULAR CENTER PLLC (NPI 1801194352) is a healthcare organization registered as an interventional cardiology in Lake Havasu City, Arizona and active in the NPI registry since March 2011. The organization holds 2 active CLIA laboratory certificates and lists Fadi Atassi, Owner/member, as its authorized official.

NPPES Registry Identity

NPI1801194352
Entity TypeOrganization
Primary Taxonomy207RI0011X
Legal Business NameLAKESIDE HEART AND VASCULAR CENTER PLLC
Location Address1741 MESQUITE AVE, SUITE A100Lake Havasu City, AZ 86403-5695
Mailing AddressPo Box 3539Lake Havasu City, AZ 86405-3539 · (928) 453-2727 · Fax (928) 453-2828
Phone(928) 453-2727
Fax(928) 453-2828
Organization SubpartNo
Authorized OfficialFadi AtassiOwner/member · (928) 453-2727
Enumeration DateMarch 8, 2011
Last NPPES UpdateJuly 20, 2011
✔ NPI 1801194352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
License✔ Licensed in AZ · 44211
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 44211 (AZ)
1741 MESQUITE AVE, Lake Havasu City, AZ 86403
Open in Google Maps ↗

Other Identifiers 3

Medicare PINZAZ
Medicaid604490AZ
OtherP-1663566-8AZ · Arizona Corporation Commission Filing Number

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health.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 Heart And Vascular Center Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

36

Medicare enrollment records show 36 clinicians reassign Medicare billing to Lakeside Heart And Vascular Center PLLC, which bills Medicare for the services they deliver. Of these, 15 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 9

Nurse Practitioner12
Cardiovascular Disease (Cardiology)7
Internal Medicine5
Interventional Cardiology5
Family Practice3
Cardiac Electrophysiology1
Endocrinology1
General Practice1
1 other specialty1

Nearest to this location (20)

See all 36
Brittney Mahnke, ACNP-AG
Nurse Practitioner
NPI 1265091276
101 CIVIC CENTER LN
Lake Havasu City, AZ 86403
(928) 302-5402
✔ PECOS✔ Accepts Medicare0.1 mi
Ashley Mulder, MD
Family Practice
NPI 1104455989
1851 MESQUITE AVE STE 202
Lake Havasu City, AZ 86403
(928) 854-0094
✔ PECOS✔ Accepts Medicare0.2 mi
Gene Kalin, M.D.
Internal Medicine
NPI 1649272030
1840 MESQUITE AVE STE B
Lake Havasu City, AZ 86403
(928) 855-1016
✔ PECOS0.3 mi
Edward Quinn, MD
Cardiovascular Disease (Cardiology)
NPI 1184624421
150 RIVIERA DR
Lake Havasu City, AZ 86403
(928) 855-5090
✔ PECOS✔ Accepts Medicare0.4 mi
Patricia Folden, FNP
Nurse Practitioner
NPI 1356870695
2010 INJO DR
Lake Havasu City, AZ 86403
(928) 412-8420
✔ PECOS✔ Accepts Medicare0.4 mi
Jenniffer Blair, FNP-C
Nurse Practitioner
NPI 1265804124
309 LAKE HAVASU AVE S
Lake Havasu City, AZ 86403
(928) 453-2727
✔ PECOS✔ Accepts Medicare0.5 mi
Christina Rozelle, FNP-C
Nurse Practitioner
NPI 1619779139
2035 MESQUITE AVE
Lake Havasu City, AZ 86403
(928) 208-4598
✔ PECOS✔ Accepts Medicare0.6 mi
Sara Rubio, AGACNP-BC
Nurse Practitioner
NPI 1326513136
2035 MESQUITE AVE
Lake Havasu City, AZ 86403
(928) 208-4598
✔ PECOS✔ Accepts Medicare0.6 mi
Rafael Francisco Go, MD, MBA, MS
Interventional Cardiology
NPI 1699296319
2082 MESQUITE AVE STE A
Lake Havasu City, AZ 86403
(928) 453-2727
✔ PECOS✔ Accepts Medicare0.6 mi
George Jolly, M.D.
Cardiovascular Disease (Cardiology)
NPI 1427504299
2082 MESQUITE AVE STE 100A
Lake Havasu City, AZ 86403
(928) 453-2727
✔ PECOS✔ Accepts Medicare0.6 mi
Paul Mahnke, ACNPC-AG
Nurse Practitioner
NPI 1982123618
2082 MESQUITE AVE
Lake Havasu City, AZ 86403
(928) 453-2727
✔ PECOS✔ Accepts Medicare0.6 mi
Aditya Goud, M.D.
Interventional Cardiology
NPI 1073929550
2082 MESQUITE AVE STE 100A
Lake Havasu City, AZ 86403
(928) 453-2727
✔ PECOS✔ Accepts Medicare0.7 mi
Fadi Atassi, MD
Internal Medicine
NPI 1851553119
2082 MESQUITE AVE SUITE A100
Lake Havasu City, AZ 86403
(928) 453-2727
✔ PECOS✔ Accepts Medicare0.7 mi
Craig Levy, MD
Family Practice
NPI 1528150455
309 LAKE HAVASU AVE S
Lake Havasu City, AZ 86403
(928) 453-1970
✔ PECOS✔ Accepts Medicare0.7 mi
Blondena Miley, FNP
Nurse Practitioner
NPI 1013580687
309 LAKE HAVASU AVE S
Lake Havasu City, AZ 86403
(928) 453-1970
✔ PECOS✔ Accepts Medicare0.7 mi
Nicole Roberts, FNP
Nurse Practitioner
NPI 1972158624
5717 S HIGHWAY 95 STE 4
Fort Mohave, AZ 86426
(928) 577-2727
✔ PECOS✔ Accepts Medicare38 mi
Mahmood Khan, M.D.
Internal Medicine
NPI 1336339175
2002 N STOCKTON HILL RD STE 104
Kingman, AZ 86401
(928) 692-1010
✔ PECOS✔ Accepts Medicare53 mi
Julie Waite, ARNP
Nurse Practitioner
NPI 1245268788
2501 N STOCKTON HILL RD STE 108
Kingman, AZ 86401
(928) 255-5050
✔ PECOS✔ Accepts Medicare53 mi
Ruth Franco, NURSE PRACTITIONER
Nurse Practitioner
NPI 1114661758
3269 N STOCKTON HILL RD
Kingman, AZ 86409
(928) 292-0929
✔ PECOS✔ Accepts Medicare54 mi
Alie Jreisat, MD
Family Practice
NPI 1578130555
3931 N STOCKTON HILL RD
Kingman, AZ 86409
(928) 385-7100
✔ PECOS✔ Accepts Medicare55 mi
See all 36 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2025537

Lakeside Heart And Vascular Center, PLLC · Lake Havasu City, AZ
Active · expires Jun 9, 2027
CLIA Number03D2025537
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2025
Certificate Expiration DateJune 9, 2027
Laboratory DirectorFadi Atassi
Laboratory Phone(928) 453-2727
Laboratory LocationLakeside Heart And Vascular Center, PLLC2082 Mesquite Ave, #100a, Lake Havasu City, AZ 86403
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2212829

Lakeside Heart And Vascular Center-Kingman · Kingman, AZ
Active · expires Feb 7, 2027
CLIA Number03D2212829
Laboratory TypePhysician Office
Certificate Effective DateFebruary 8, 2025
Certificate Expiration DateFebruary 7, 2027
Laboratory DirectorFadi Atassi
Laboratory Phone(928) 453-2727
Laboratory LocationLakeside Heart And Vascular Center-Kingman1753 Airway Avenue, Ste A, Kingman, AZ 86409
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Heart And Vascular Center PLLC's NPI number?

The NPI number for Lakeside Heart And Vascular Center PLLC is 1801194352. It was assigned to this organization in the NPPES registry on March 8, 2011.

Where is Lakeside Heart And Vascular Center PLLC located?

Lakeside Heart And Vascular Center PLLC is located at 1741 Mesquite Ave Suite A100, Lake Havasu City, AZ 86403. The listed phone number is (928) 453-2727.

What is Lakeside Heart And Vascular Center PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Lakeside Heart And Vascular Center PLLC enrolled in Medicare?

Yes. Lakeside Heart And Vascular Center PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lakeside Heart And Vascular Center PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 36 clinicians in 9 Medicare specialties reassign their Medicare billing to Lakeside Heart And Vascular Center PLLC. 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 Nurse Practitioner (12), Cardiovascular Disease (Cardiology) (7) and Internal Medicine (5). Of these, 15 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lakeside Heart And Vascular Center PLLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Lakeside Heart And Vascular Center PLLC accept?

Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Lakeside Heart And Vascular Center PLLC 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 Heart And Vascular Center PLLC was last updated on July 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.