Lakeside Family Foot Care – Foot & Ankle Surgery Podiatrist, NPI 1295904183

Lakeside Family Foot Care is a healthcare provider. based in Reno, Nevada. specializing in Foot & Ankle Surgery Podiatrist. The organization holds a License No. 9004 (NV). The NPI Number for Lakeside Family Foot Care is 1295904183

Main info

Organization
Name
Lakeside Family Foot Care
NPI
1295904183
Phone
(775) 825-2533
Address
3495 LAKESIDE DR
Authorized Official
MR. RAYMOND GLENN ROBERTS PRESIDENT DPM
Enumeration Date
25 February 2008
Last Update Date
16 June 2008
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Lakeside Family Foot Care

  • 3495, Lakeside Drive, Reno, Washoe County, Nevada, 89509, United States

    #243

    RENO, NV 895094841

    Phone: (775) 825-2533

    Fax: (775) 825-1263

    Type: Mailing

  • 6580, South McCarran Boulevard, Reno, Washoe County, Nevada, 89509, United States

    STE. D-1

    RENO, NV 895096112

    Phone: (775) 825-2533

    Fax: (775) 826-9546

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-04-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040423001324OClinic/Group PracticeNVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89509)

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Reviews

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Frequently asked questions

How do I look up Lakeside Family Foot Care by NPI?
Use NPI 1295904183 when you need to reference Lakeside Family Foot Care in forms, claims, or directories.
Is Lakeside Family Foot Care active in the national directory?
Lakeside Family Foot Care's public NPI profile is in an active state.
What kind of provider is Lakeside Family Foot Care?
The page reflects Foot & Ankle Surgery Podiatrist for Lakeside Family Foot Care. Clinical services aligned with this taxonomy classification.
What location metadata exists for Lakeside Family Foot Care?
The page summarizes Reno, Nevada for Lakeside Family Foot Care; expand the address list for detail.
How can I contact Lakeside Family Foot Care?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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