NPIMap

Individual provider Active NPI

Tierney A Lake, MD

  • Hospitalist Physician
  • Durango, CO
National Provider Identifier
1194041210
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DR.0052399 Issued in CO
Practice address
1010 Three Springs Blvd
Durango, CO 81301-8296
Phone
(970) 764-3352
Fax
(970) 764-3375
NPI assigned
Apr 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0052399 CO
Hospitalist Physician 208M00000X DR.0052399 CO Primary

Addresses

Primary practice location

1010 Three Springs Blvd
Durango, CO 81301-8296

Mailing address

PO Box 800022
Kansas City, MO 64180-0022
Phone (800) 953-0104

Other practice location 1

300 S Nevada Ave
Montrose, CO 81401-4273
Phone (970) 249-7751 ext. 23

Other practice location 2

100 Health Park Dr
Louisville, CO 80027-9583
Phone (303) 673-1000

Other identifiers 1

IdentifierTypeStateIssuer
52399OtherCOSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130917000656 CO Practitioner - HospitalistPractitioner - Internal Medicine 5395989180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Colorado School of Medicine, Denver, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

1010 Three Springs Blvd
Durango, CO 81301-8296

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Sep 1, 2019 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Iniatives Colorado Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Uncompahgre Combined Clinics Past Accepting new patients
Mountain Radiology, Inc Past Accepting new patients
Community Medical Group, LLC Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

1010 Three Springs Blvd
Durango, CO 81301
Phone (970) 247-4311

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1194041210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800022",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "970-764-3352",
            "fax_number": "970-764-3375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S Nevada Ave",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "CO",
            "postal_code": "814014273",
            "country_code": "US",
            "telephone_number": "970-249-7751 x23",
            "fax_number": "970-249-5029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Health Park Dr",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800279583",
            "country_code": "US",
            "telephone_number": "303-673-1000",
            "fax_number": "303-673-1204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "TIERNEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0052399",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0052399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "52399",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.