Kevin C Lake, RPA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

010298 Issued in NY

Practice address

475 Irving Ave
Suite 418
Syracuse, NY 13210-1756

Phone

(315) 426-0190

Fax

(315) 426-0192

NPI assigned

Apr 7, 2006

Last updated

Jun 18, 2009By 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 NY

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Syracuse Orthopedic Specialists, PLLCGroup PAC ID 6406760073, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Syracuse Orthopedic Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Syracuse, NY
  • NPI 1669410379
  Medicare reassignment Care Compare group NPD
• Cny North Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1962901389
  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1841253341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "address_2": "SUITE 418",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101756",
            "telephone_number": "315-426-0190",
            "fax_number": "315-426-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "address_2": "SUITE 418",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101756",
            "telephone_number": "315-426-0190",
            "fax_number": "315-426-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "KEVIN",
        "middle_name": "C",
        "credential": "RPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "010298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carina Lagua, MA, RD, CDE, CDN
• Rosario F Laguzza, DDS, PC
• Ian Perry Laih
• Emily Marie Laird
• Alexandria Lake
• Lakhan LLC
• Mary Joanne Lakomski, RPH
• Divakar N Lal, MD
• Gurdeep Lal
• Padma Lal, M.D.

• Medical Physician Assistant in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.