Mark A Lake (NPI# 1104848423, PAC ID# 2365425857) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1104848423 |
| PAC ID by PECOS | 2365425857 |
| Professional Enrollment ID | I20040607001474 |
| Full Name | Mark A Lake |
| Address |
15 Executive Dr Suite 4 Lafayette IN 47905-4868 |
| Gender | M |
| Credential | MD |
| Medical School | WRIGHT STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | DERMATOLOGY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150173 | INDIANA UNIVERSITY HEALTH ARNETT HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 15 Executive Dr, Suite 4, Lafayette, IN 47905-4868 | ||
| 810 S 6th St B, Iu White County Memorial Hospital, Monticello, IN 47960-8201 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 100% | |
| MIPS_EC_138_overall | Melanoma: Coordination of Care | 63% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 100% | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 97% |
| Street Address |
15 EXECUTIVE DR SUITE 4 |
| City | LAFAYETTE |
| State | IN |
| Zip | 47905-4868 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Alane Lewis | Optometry | Myeyedr Optometry of Indiana LLC | 100 S Creasy Ln, Suite 1530, Lafayette, IN 47905-0757 |
| Melissa A Gwin | Nurse Practitioner | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Vishal Viswam | Psychiatry | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Sonia B Yballe | Psychiatry | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Azubike Nwokedi | Nurse Practitioner | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Kathleen Jane Halverson | Nurse Practitioner | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Timothy Poquette | Nurse Practitioner | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Morgan Amelia Mccormick | Psychiatry | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Olaniyi O Osuntokun | Psychiatry | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Katherine M Hafer | Nurse Practitioner | Sycamore Springs Physician Group LLC | 833 Park E Blvd, Lafayette, IN 47905-0785 |
| Find all physicians in zip 47905 | |||
| City | LAFAYETTE |
| Zip Code | 47905 |
| Specialty | DERMATOLOGY |
| City + Specialty | LAFAYETTE + DERMATOLOGY |
Please comment or provide details below to improve the information on Mark A Lake.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.