Melissa Lake, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA6641 Issued in MA

Practice address

800 W Cummings Park Ste 1200
Woburn, MA 01801-6587

Phone

(781) 927-7246

Fax

(781) 305-4683

NPI assigned

Jul 17, 2018

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

Not listed in the public Medicare enrollment file

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.

• North Shore Anesthesia, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Beverly, MA
  • NPI 1295043297
  NPD (past)

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1922584499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CTR STE 221U",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156183",
            "telephone_number": "978-927-7246",
            "fax_number": "978-927-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CUMMINGS PARK STE 1200",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016587",
            "telephone_number": "781-927-7246",
            "fax_number": "781-305-4683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Cummings Ctr Ste 221U",
            "address_purpose": "LOCATION",
            "city": "Beverly",
            "state": "MA",
            "postal_code": "019156183",
            "country_code": "US",
            "telephone_number": "978-927-7246",
            "fax_number": "978-927-7249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "MELISSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA6641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sebastien Labissiere
• Catherine Mary Lacouture, MS, OTR/L
• Lady Grace Stores, Inc.
• Christina Lafalaise
• Tanya Lai, LCSW
• Kirti Kaur Lamba
• Joanne Lamontagne, PT
• Landjet,Inc.
• Enid S Landreth, RN
• Bernadette Lane, PNP

• Medical Physician Assistant in Woburn, MA
• Providers in Woburn, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.