LAKESIDE SURGERY PA
NPI 1831468800
Surgery in Rockwall, TX
About Lakeside Surgery Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE SURGERY PA (NPI 1831468800) is a healthcare organization registered as a surgery in Rockwall, Texas and active in the NPI registry since December 2011. The organization lists Terri R Phillip, Practice Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 5
Group Practice 1
Accepted Insurance
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)
Lakeside Surgery Pa 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
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Lakeside Surgery PA, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
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 Surgery PA's NPI number?
The NPI number for Lakeside Surgery PA is 1831468800. It was assigned to this organization in the NPPES registry on December 21, 2011.
Where is Lakeside Surgery PA located?
Lakeside Surgery PA is located at 4450 Tubbs Rd, Rockwall, TX 75032. The listed phone number is (972) 772-3290.
What is Lakeside Surgery PA's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Lakeside Surgery PA enrolled in Medicare?
Yes. Lakeside Surgery PA is registered in the Medicare PECOS enrollment system.
When is Lakeside Surgery PA'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 (Texas, 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 Lakeside Surgery PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in General Surgery, reassign their Medicare billing to Lakeside Surgery PA. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Lakeside Surgery PA accept?
Health plans from WellPoint list Lakeside Surgery PA 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 Surgery PA was last updated on June 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 Surgery Pa · NPI 1831468800
Surgery organization in Rockwall, Texas. Organization record, active in the CMS NPPES registry since December 21, 2011.
## Identity
- **NPI:** 1831468800 (Entity type: Organization)
- **Enumerated:** December 21, 2011
- **Primary specialty:** Surgery · taxonomy 208600000X
- **Organization subpart:** No
- **Authorized official:** Terri Phillip, PRACTICE MANAGER
## Practice location
- **Address:** 4450 TUBBS RD, Rockwall, TX 75032-6308
- **Phone:** (972) 772-3290 · **Fax:** (972) 722-3815
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians (General Surgery) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 20, 2018
- **Other identifiers:** Other 1326097676 (TX); Other J2983 (TX); Other 1952393415 (TX); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1831468800) · Data from the CMS NPPES public registry.