Lake City Primary Care PLLC
NPI 1164850053 · Family Medicine Physician · Plattsburgh, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake City Primary Care PLLC is a Family Medicine Physician organization in Plattsburgh, NY (NPI 1164850053).
Provider details
- NPI number
- 1164850053
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kelley Brault, Office Manager(518) 561-8256
- License
- 210018 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Richard a Webber Dba Lake City Primary Care
Registry dates
- Enumerated
- 2013-10-31
- Last updated
- 2014-01-17
Frequently asked questions
- What is Lake City Primary Care PLLC's NPI number?
- Lake City Primary Care PLLC's National Provider Identifier (NPI) is 1164850053, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake City Primary Care PLLC?
- Lake City Primary Care PLLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Lake City Primary Care PLLC located?
- Lake City Primary Care PLLC's practice location on file with NPPES is 16 Degrandpre Way, Plattsburgh, NY 12901-6451.
- What is Lake City Primary Care PLLC's phone number?
- The practice phone number listed in the NPPES registry for Lake City Primary Care PLLC is (518) 561-8256.
- Does Lake City Primary Care PLLC accept Medicare?
- Lake City Primary Care PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake City Primary Care PLLC?
- The authorized official listed on Lake City Primary Care PLLC's NPPES record is Kelley Brault, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake City Primary Care PLLC's NPI active?
- Yes — Lake City Primary Care PLLC's NPI (1164850053) is active in the NPPES registry as of the last update on 2014-01-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.