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LAKESIDE CHIROPRACTIC PC
NPI 1992713903
Chiropractor in Conneaut Lake, PA

Active since August 04, 2006
10633 STATE HIGHWAY 18, CONNEAUT LAKE, PA 16316(814) 382-1970(814) 382-3619 Get Directions Write a Review

NPPES record last updated: May 3, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lakeside Chiropractic Pc NPPES

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

LAKESIDE CHIROPRACTIC PC (NPI 1992713903) is a healthcare organization registered as a chiropractor in Conneaut Lake, Pennsylvania and active in the NPI registry since August 2006. The organization lists Timothy B Vyrostek, Clinic Director, as its authorized official.

NPPES Registry Identity

NPI1992713903
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameLAKESIDE CHIROPRACTIC PC
Location Address10633 STATE HIGHWAY 18Conneaut Lake, PA 16316-3225
Mailing Address10633 State Highway 18Conneaut Lake, PA 16316-3225 · (814) 382-1970 · Fax (814) 382-3619
Phone(814) 382-1970
Fax(814) 382-3619
Organization SubpartNo
Authorized OfficialTimothy B VyrostekClinic Director · (814) 382-1970
Enumeration DateAugust 4, 2006
Last NPPES UpdateMay 3, 2023
NPPES CertifiedMay 3, 2023
✔ NPI 1992713903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
10633 STATE HIGHWAY 18, Conneaut Lake, PA 16316
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Other Identifiers 2

Other350056097PA · Palmetto Gba
Other350056097PA · Rr Medicare

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 SINGLE SPECIALTY GROUP

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 Chiropractic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

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.

StateEnrollment IDDue date
StatePennsylvaniaEnrollment IDO20050414000039Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lakeside Chiropractic PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Timothy Vyrostek, DC CCSP
Chiropractic
NPI 1003929308
10633 STATE HIGHWAY 18
Conneaut Lake, PA 16316
(814) 382-1970
✔ PECOSSame address

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 Chiropractic PC's NPI number?

The NPI number for Lakeside Chiropractic PC is 1992713903. It was assigned to this organization in the NPPES registry on August 4, 2006.

Where is Lakeside Chiropractic PC located?

Lakeside Chiropractic PC is located at 10633 State Highway 18, Conneaut Lake, PA 16316. The listed phone number is (814) 382-1970.

What is Lakeside Chiropractic PC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Lakeside Chiropractic PC enrolled in Medicare?

Yes. Lakeside Chiropractic PC is registered in the Medicare PECOS enrollment system.

When is Lakeside Chiropractic PC'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 (Pennsylvania, Clinic/Group Practice) is due for revalidation by November 30, 2026. 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 Chiropractic PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Lakeside Chiropractic PC. 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 Chiropractic PC was last updated on May 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.