Active NPI
Melanie J Lake, PA
- Physician Assistant
- Burnt Hills, NY
National Provider Identifier
1962618819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 007368
- Practice address
- 848 State Route 50
Burnt Hills, NY 12027-9511 - Phone
- (518) 831-1500
- Fax
- (518) 377-1677
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 007368 | NY | Primary |
Addresses
Primary practice location
848 State Route 50
Burnt Hills, NY 12027-9511
Mailing address
848 State Route 50
Burnt Hills, NY 12027-9511
Phone (518) 831-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02054451 | Medicaid | NY |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
848 State Route 50
Burnt Hills, NY 12027-9511
Phone 51883115001100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Gastroenterology Physician
- Burnt Hills, NY
- NPI 1093724767
Hospital & facility affiliations 20
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Schenectady, NY
- NPI 1487644993
-
- Endocrinology, Diabetes & Metabolism Physician
- Gansevoort, NY
- NPI 1033371166
Hospital
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1073569331
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1093078560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739404800000",
"number": "1962618819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "848 STATE ROUTE 50",
"city": "BURNT HILLS",
"state": "NY",
"postal_code": "120279511",
"telephone_number": "518-831-1500",
"fax_number": "518-377-1677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "848 STATE ROUTE 50",
"city": "BURNT HILLS",
"state": "NY",
"postal_code": "120279511",
"telephone_number": "518-831-1500",
"fax_number": "518-377-1677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "MELANIE",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2025-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "007368",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02054451",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burnt Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.