CATHERINE DETTELBACH LAKE (FNP-C) – Nurse Practitioner, NPI 1265039424
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for CATHERINE DETTELBACH LAKE (FNP-C)
915 W MONROE ST STE 200
JACKSONVILLE, FL 322041177
Phone: (904) 384-2240
Fax: (904) 486-2314
Type: Location
3411 SHENANDOAH DR W
ORANGE PARK, FL 320736631
Phone: (904) 294-4512
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $468.
Total Amount is formed as General ($468) + Research ($0) + Ownership ($0) = $468.
Last reported payment date: 2023-09-23 • Largest payer in this snapshot: Dexcom, Inc. ($249).
Total Amount
$468
General + Research + Ownership
Payments
4
Total payment records
General Amount
$468
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $249 |
| Insulet Corporation | $125 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $95 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-02-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210226000169 | I | Nurse Practitioner | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 574 | 289 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 466 | 258 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 216 | 206 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 32204)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| - | FL | |
| E N D O C R I N O L O G Y | FL | |
| E N D O C R I N O L O G Y | FL | |
| - | PA | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| - | FL |
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