Angel Anthony Lake, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1365 Issued in VI

Practice address

4007 Diamond Ruby
Christiansted, VI 00820

Phone

(340) 778-6311

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VI

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

Internal Medicine

Education

Michigan State University College of Human Medicine, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gov Juan F Luis Hospital & Medical Ctr Hospital, St Croix, VI, CCN 480002

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.

• Angel Lake, MD

  • Internal Medicine Physician
  • Christiansted, VI
  • NPI 1063237360
  NPD Authorized official
• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  NPD (past)

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

• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Care Compare affiliation

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1205978335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 371",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008210371",
            "telephone_number": "340-778-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 DIAMOND RUBY",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "00820",
            "telephone_number": "340-778-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "ANGEL",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VI",
            "license": "1365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VI LIC NUMBER",
            "identifier": "1365",
            "state": "VI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josephine Widjaja Kozloff, PA-C
• Lindsey Lee Kranson, PA
• Peter M Kumpitch, OD
• La Paz Hospice Care Inc.
• La Paz Hospice Care, Inc
• Ramesh Billy Lakhram, M.D.
• Carie Olevia Landrum, FNP
• Leeward Islands Apothecaries LLC
• Larissa Leffingwell, PA-C
• Jamie Leonard, RBT

• Internal Medicine Physician in Christiansted, VI
• Providers in Christiansted, VI by specialty
• Internal Medicine Physician in U.S. Virgin Islands

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.