OrganizationActive
Lake Hospital System
NPI 1326141987 · Family Medicine Physician · Willowick, OH
Provider details
- NPI number
- 1326141987
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Lake Hospital System
- Organization subpart
- Yes
- Authorized official
- Robert Tracz, Chief Financial Officer(440) 354-1051
- License
- 35-084193 (OH)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
29804 Lakeshore Blvd
Willowick, OH 44095
Phone: (440) 833-2095
Fax: (440) 833-2096
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 714328
Columbus, OH 43271-4328
Other names (DBA / former)
- Doing business as
- Primehealth Willowick Primary Care
Registry dates
- Enumerated
- 2006-09-07
- Last updated
- 2008-04-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.