Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Lakeside Nursing Home, Inc

Skilled Nursing Facility in Ithaca, NY · enumerated 2007 · authorized official Patrick Deptula, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1053535617

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Registry record

Entity type Organization (Type 2)

Legal business name Lakeside Nursing Home, Inc

Practice address 1229 Trumansburg Road, Ithaca, NY, 14850

Phone (607) 273-8072

Fax (607) 273-0373

Enumeration date Apr 12, 2007

Last updated in NPPES Aug 22, 2020

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities · License 5401307N (NY) Primary

Authorized official

Name Patrick Deptula

Title Administrator

Phone (607) 273-8072

Other identifiers

Identifier	Type	State	Issuer
00308181	Medicaid	NY	-
000900083000	Other	NY	HEALTH NOW

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.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-08-22. Verify at npiregistry.cms.hhs.gov.

Where is Lakeside Nursing Home, Inc located?

The practice location on file with NPPES is in Ithaca, NY.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.