Mark Adrian Lake, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01055166 Issued in IN

Practice address

15 Executive Dr
Suite 4
Lafayette, IN 47905-3833

Phone

(765) 838-3428

Fax

(765) 838-3440

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Wright State University Boonshoft School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173

Merit-based Incentive Payment System (MIPS)

Final score

96.7 of 100Reported as individual

Quality

93.99

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kschumm@lake.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lake Dermatology Inc.

  • Dermatology Physician
  • Lafayette, IN
  • NPI 1689898447
  Medicare reassignment NPD Authorized official
• Riggs Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1386660900
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Arnett Inc

  • General Acute Care Hospital
  • Lafayette, IN
  • NPI 1326296211
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1104848423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EXECUTIVE DR",
            "address_2": "SUITE 4",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479053833",
            "telephone_number": "765-838-3428",
            "fax_number": "765-838-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 EXECUTIVE DR",
            "address_2": "SUITE 4",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479053833",
            "telephone_number": "765-838-3428",
            "fax_number": "765-838-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "MARK",
        "middle_name": "ADRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01055166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kschumm@lake.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15 Executive Dr",
            "address_2": "Suite 4",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479053833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Whitney Marie Lahrman, RD, LD
• Anna Lai
• Khoa D Lai, MD
• Lake Dermatology Inc.
• Emily Lake, PTA
• Lakewood Family Dental of Lafayette Inc
• James M. Lalonde, D.D.S.
• Nancy Lam, DC
• Elizabeth Ann Lana, RN,CDE
• Carol Callahan Lancaster, NP

• Dermatology Physician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.