Individual provider Active NPI

Drew Erica Lakey

  • Medical Physician Assistant
  • Grants Pass, OR
National Provider Identifier
1609443589
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
214110 Issued in OR
Practice address
1309 NE 6TH St
Grants Pass, OR 97526-1252
Phone
(541) 479-3367
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 60671 CA
Medical Physician Assistant 363AM0700X 214110 OR Primary

Addresses

Primary practice location

1309 NE 6TH St
Grants Pass, OR 97526-1252

Mailing address

4517 Radnor Ave
Lakewood, CA 90713-2550
Phone (562) 508-1089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230316000891 OR Practitioner - Physician Assistant 8022403419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David F Young MD PCGroup PAC ID 2466440292, 4 clinicians

Practice addresses (Care Compare)

1309 NE 6TH St
Grants Pass, OR 97526-1252
Phone (541) 479-3367

Hospital & facility affiliations

  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
60671CAMDMedical Physician Assistant
214110ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
La Laser Center PC, a Professional Medical Corporation PastSince Feb 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: drew@davidyoung.emadirect.md

Organizations & group practices 2

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 1

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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1609443589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 RADNOR AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907132550",
            "telephone_number": "562-508-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 NE 6TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261252",
            "telephone_number": "541-479-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKEY",
        "first_name": "DREW",
        "middle_name": "ERICA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "60671",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "214110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.