Donald Lake, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704210937 Issued in MI

Practice address

1221 Pine Grove Ave
McIaren Port Huron
Port Huron, MI 48060

Phone

(810) 987-5000

Fax

(810) 985-2669

NPI assigned

Jun 29, 2017

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 MI

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

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren Port HuronGroup PAC ID 9931018702, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• McLaren Port Huron

  • Psychiatry Physician
  • Port Huron, MI
  • NPI 1386888170
  Medicare reassignment Care Compare group NPD
• McLaren Greater Lansing

  • Gynecologic Oncology Physician
  • Lansing, MI
  • NPI 1265600902
  Medicare reassignment
• McLaren Macomb

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1396014601
  Medicare reassignment
• McLaren Port Huron

  • Family Medicine Physician
  • Port Huron, MI
  • NPI 1619355930
  NPD

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

• McLaren Port Huron

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1982685384
  Care Compare affiliation

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1871014944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "address_2": "MCIAREN PORT HURON",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-987-5000",
            "fax_number": "810-985-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "address_2": "MCIAREN PORT HURON",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-987-5000",
            "fax_number": "810-985-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "DONALD",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704210937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Lacroix
• Melody Lacroix
• Kathleen Elizabeth Laduke
• Cynthia Lee Laeder, CRNA
• Michael Alan Laeder, RPH
• Margaret Lake
• Lakeside Pediatric Dental Specialists
• Lakeview Chiropractic Inc
• Jenna Marie Lakin
• Anup Lal, MD

• Family Nurse Practitioner in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.