Lakeside Orthopedic Institute LLC
NPI 1275564916ActiveOrganization· Orthopaedic Surgery· Lake Havasu City, AZ
Orthopaedic Surgery in Lake Havasu City, Arizona, registered in NPPES in July 2006. The authorized official on file is Daniel Edward Heiner, MD, Managing Partner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1275564916 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 5, 2006 |
| Last updated in NPPES | May 5, 2026 |
| Certified by provider | May 5, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Orthopaedic Surgery Primary | 207X00000X | — | — |
| Orthopaedic Surgery | 207X00000X | 13802 | AZ |
| Orthopaedic Surgery | 207X00000X | 23186 | AZ |
| Orthopaedic Surgery | 207X00000X | 34564 | AZ |
| Orthopaedic Surgery | 207X00000X | 26379 | AZ |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | 0554 | AZ |
| Physical Therapist | 225100000X | 2641 | AZ |
| Physical Therapist | 225100000X | 8192 | AZ |
| Physical Therapist | 225100000X | 6762 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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