Individual provider Active NPI

Tate Allen Lage, D.O.

  • Pediatrics Physician
  • Clear Lake, IA
National Provider Identifier
1770849333
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO-04690 Issued in IA
Practice address
401 S 15TH St
Clear Lake, IA 50428-2303
Phone
(641) 357-7442
Fax
(641) 357-3070
NPI assigned
Apr 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO-04690 IA Primary

Addresses

Primary practice location

401 S 15TH St
Clear Lake, IA 50428-2303

Mailing address

401 S 15TH St
Clear Lake, IA 50428-2303
Phone (641) 357-7442

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tlage3949936@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20150908001396 IA Practitioner - Pediatric Medicine 6103064316 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Iowa Mercy Clinics CurrentSince Aug 31, 2015 Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics CurrentSince Aug 31, 2015 Accepting new patients
North Iowa Mercy Clinics Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

401 S 15th St
Clear Lake, IA 50428
Phone (641) 357-3393

Interoperability endpoints

  • Direct secure messaging: tlage3949936@direct.trinity-health.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1770849333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S 15TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504282303",
            "telephone_number": "641-357-7442",
            "fax_number": "641-357-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S 15TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504282303",
            "telephone_number": "641-357-7442",
            "fax_number": "641-357-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGE",
        "first_name": "TATE",
        "middle_name": "ALLEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "DO-04690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlage3949936@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "MercyOne North Iowa Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "401 S 15th St",
            "city": "Clear Lake",
            "state": "IA",
            "country_code": "US",
            "postal_code": "504282303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clear Lake, IA

Sources for this page

Verify at the official NPI Registry.