East Lake Medical, PLLC
NPI 1497494777ActiveOrganization· Nurse Practitioner· Tyler, TX
Nurse Practitioner in Tyler, Texas, registered in NPPES in June 2022. The authorized official on file is Jena Decanter, NP, Nurse Practitioner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1497494777 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 3, 2022 |
| Last updated in NPPES | Jun 3, 2022 |
| Certified by provider | Jun 3, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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