Jason S. Lake, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO3409 Issued in MO

Practice address

601 E Russell Ave
Warrensburg, MO 64093-9605

Phone

(660) 747-2020

Fax

(660) 747-0574

NPI assigned

May 22, 2006

Last updated

Nov 21, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Specialties of Missouri LLCGroup PAC ID 9931421187, 12 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Eyecare Specialties of Missouri LLC

  dba Eyecare Specialites

  • Optometrist
  • Warrensburg, MO
  • NPI 1730596248
  Medicare reassignment Care Compare group
• Eyecare Specialties of Missouri LLC

  dba Eyecare Specialties

  • Optometrist
  • Clinton, MO
  • NPI 1053427435
  Authorized official Same address or phone
• Lake and Lake Optometry PC

  dba Eyecare Specialties

  • Optometrist
  • Warrensburg, MO
  • NPI 1619920576
  Authorized official Same address or phone
• Eyecare Specialties of Missouri LLC

  dba Eyecare Specialties

  • Optometrist
  • Sedalia, MO
  • NPI 1053482711
  NPD (past)
• Sabates Eye Centers, PA

  • Ophthalmology Physician
  • Topeka, KS
  • NPI 1891251419
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1629022777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E RUSSELL AVE",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640939605",
            "telephone_number": "660-747-2020",
            "fax_number": "660-747-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E RUSSELL AVE",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640939605",
            "telephone_number": "660-747-2020",
            "fax_number": "660-747-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "JASON",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Nicole Krause, APRN
• Thomas Krause, DPT
• Logan Marie Kroenke, PT, DPT
• Laboratory Corporation of America Holdings
• Lake and Lake Optometry PC (Eyecare Specialties)
• Susan Lake, O.D.
• Lawrence Paul Landwehr, M.D.
• Mallory Langkrahr, LCSW
• Courtney Ann Langston, LCSW
• Lindsay Ann Lawrence, DPT, ATC

• Optometrist in Warrensburg, MO
• Providers in Warrensburg, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.