Emma Lake, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

905 N Main St
Adrian, MI 49221-2173

Phone

(517) 295-1066

NPI assigned

Jun 15, 2021

Sex

Female

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 PA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahn Observation Group, LLCGroup PAC ID 1557753811, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forbes Hospital Hospital, Monroeville, PA, CCN 390267
• Jefferson Hospital Hospital, Jefferson Hills, PA, CCN 390265

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Ahn Observation Group LLC

  • Emergency Medicine Physician
  • Jefferson Hills, PA
  • NPI 1437814696
  Medicare reassignment Care Compare group
• Ahn Emergency Group of Erie County LTD.

  • Emergency Medicine Physician
  • Erie, PA
  • NPI 1336564798
  Medicare reassignment
• Ahn Emergency Group of Forbes LTD.

  • Emergency Medicine Physician
  • Monroeville, PA
  • NPI 1235554692
  Medicare reassignment
• Ahn Emergency Group of Jefferson LTD

  • Emergency Medicine Physician
  • Jefferson Hills, PA
  • NPI 1235518499
  Medicare reassignment
• Battle Creek Urgent Care Walk in Clinic PC

  • Urgent Care Clinic/Center
  • Battle Creek, MI
  • NPI 1700539251
  NPD (past)

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

• Jefferson Regional Medical Center

  • Clinic/Center
  • Clairton, PA
  • NPI 1366488108

  Hospital

  Care Compare affiliation
• Jefferson Regional Medical Center

  • General Acute Care Hospital
  • Clairton, PA
  • NPI 1578560504
  Care Compare affiliation
• West Penn Allegheny Health System Inc.

  • General Acute Care Hospital
  • Monroeville, PA
  • NPI 1679592380
  Care Compare affiliation

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1891363974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14671 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393300",
            "telephone_number": "313-948-3055",
            "fax_number": "313-948-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N MAIN ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212173",
            "telephone_number": "517-295-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "EMMA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Patrick Krucek
• Monique Kunkle
• Sanjeev Kurichh, M.D.
• Shane Michael Lagore, NP
• Tracy Laing, MA, LPC
• Victoria Lambright
• Paul W Lanczki, OD
• Jennifer Marie Landstrom
• Therese M Langan, LMSW
• Kara Lange, LLPC

• Physician Assistant in Adrian, MI
• Providers in Adrian, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.