Lakeside Nursing Home, Inc
Lakeside Nursing Home, Inc is a healthcare organization registered as Skilled Nursing Facility in Ithaca, NY, holding Type 2 (organization) NPI 1053535617 since 2007. The authorized official on file is Patrick Deptula, Administrator.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1053535617 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Lakeside Nursing Home, Inc |
| Practice address | 1229 TRUMANSBURG ROAD, Ithaca, NY, 14850 |
| Phone | 6072738072 |
| Fax | 6072730373 |
| Enumeration date | 2007-04-12 |
| Last updated in NPPES | 2020-08-22 |
Authorized official
| Name | Patrick Deptula |
|---|---|
| Title | Administrator |
| Phone | 6072738072 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | Primary | 5401307N | NY |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00308181 | Medicaid | NY | — |
| 000900083000 | Other | NY | HEALTH NOW |
Copy-ready billing details
Provider: Lakeside Nursing Home, Inc NPI: 1053535617 Taxonomy: 314000000X (Skilled Nursing Facility) Address: 1229 TRUMANSBURG ROAD, Ithaca, NY, 14850
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1871820076 | Cayuga Ridge, LLC | Organization | Skilled Nursing Facility | Ithaca, NY |
Verify this record
Cross-check NPI 1053535617 against the authoritative CMS record: view Lakeside Nursing Home, Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Lakeside Nursing Home, Inc located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-08-22.