Douglas R. Lake, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

37861 Issued in IA

Practice address

1215 Duff Avenue
Ames, IA 50010-3014

Phone

(515) 239-4456

Fax

(515) 239-4761

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 12

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, IA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

University of Kansas School of Med (KC/Wich/Sal), 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McFarland Clinic PCGroup PAC ID 1254244239, 353 clinicians

Broadlawns Medical CenterGroup PAC ID 3678466166, 302 clinicians

Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Greeley Medical Center Hospital, Ames, IA, CCN 160030
• Boone County Hospital Hospital, Boone, IA, CCN 161372
• Broadlawns Medical Center Hospital, Des Moines, IA, CCN 160101
• Stanford Health Care Hospital, Stanford, CA, CCN 050441
• Story County Hospital Hospital, Nevada, IA, CCN 161333

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Medicare reassignment Care Compare group NPD
• McFarland Clinic PC

  • Multi-Specialty Clinic/Center
  • Ames, IA
  • NPI 1639135643
  Medicare reassignment Care Compare group NPD
• Stanford Health Care

  dba Stanford Medical Center A Trade Name for Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Broadlawns Medical Center

  • Pharmacy
  • Des Moines, IA
  • NPI 1013197060
  NPD
• Stanford Health Care

  dba Stanford Health Care Emeryville 5800

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1275076325

  Diagnostic Radiology

  NPD
• Stanford Health Care

  dba Stanford Health Care Specialty Pharmacy

  • Specialty Pharmacy
  • Mountain View, CA
  • NPI 1760366132
  NPD
• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  NPD (past)

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

• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  Care Compare affiliation
• Boone County Hospital

  dba Boone County Family Medicine North Walk In

  • Primary Care Clinic/Center
  • Boone, IA
  • NPI 1942664602

  Hospital

  Care Compare affiliation
• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Care Compare affiliation
• Mary Greeley Medical Center

  • General Acute Care Hospital
  • Ames, IA
  • NPI 1477539492
  Care Compare affiliation
• Story County Hospital

  dba Story County Medical Center

  • Critical Access Hospital
  • Nevada, IA
  • NPI 1215054713
  Care Compare affiliation
• Stanford Health Care

  dba SHC Radiation Oncology

  • Radiation Oncology Physician
  • Pleasanton, CA
  • NPI 1124561758

  Hospital

  Care Compare affiliation
• Stanford Health Care

  dba Stanford Health Care Emeryville 5800

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1275076325
  Care Compare affiliation
• Stanford Health Care

  dba Stanford Health Care Emeryville 6121

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1285177337
  Care Compare affiliation
• Stanford Health Care

  dba Stanford Medical Center A Trade Name for Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  Care Compare affiliation
• Stanford Health Care

  dba Stanford Health Care Pleasanton 5565

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1467990465
  Care Compare affiliation
• Stanford Health Care

  dba Stanford Medical Center A Trade Name for Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1871543215
  Care Compare affiliation
• Stanford Life Flight

  • Air Ambulance
  • Stanford, CA
  • NPI 1114063203

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1194808394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3014",
            "address_2": "1215 DUFF AVENUE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500103014",
            "telephone_number": "515-239-4456",
            "fax_number": "515-239-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 DUFF AVENUE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500103014",
            "telephone_number": "515-239-4456",
            "fax_number": "515-239-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "DOUGLAS",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "37861",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "23902",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "24188",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A99351",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NE",
            "identifier": "01626",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025186700",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173600",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69958751",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194808394",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK SELECT FIRST",
            "identifier": "200145166",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK SELECT FIRST",
            "identifier": "201477608",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00619095",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00619099",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7729430",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025248800",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NE",
            "identifier": "34783",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlake72410@directmcfarlandclinic.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1215 Duff Avenue",
            "city": "Ames",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500103014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kurt Ver Helst DC PC
• June Frances Lackore, M.S.
• Emma Ladehoff
• Tyrell Micheal Lafferty
• Marisa Lageveen
• Susan E Lang, LMHC
• Lange Homecare LLC
• Macie Langstraat
• Robert William Larrance, HEARING INSTRUMENT
• Larson Eyecare Inc

• Diagnostic Radiology Physician in Ames, IA
• Providers in Ames, IA by specialty
• Diagnostic Radiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.