DR. RUSSELL WILLIAM LAKE (MD) – Family Medicine Physician, NPI 1104081082
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,102 FAMILY PRACTICE in GA
Provider Addresses for DR. RUSSELL WILLIAM LAKE (MD)
101 ST. JOSEPH'S CANDLER DRIVE
SUITE 200
POOLER, GA 31322
Phone: (912) 748-1999
Fax: (912) 748-3847
Type: Location
10055 FORD AVENUE
SUITE 3A
RICHMOND HILL, GA 31324
Phone: (912) 819-9601
Fax: (912) 819-9605
Type: Location
836, East 65th Street, Fairfield, Savannah, Chatham County, Georgia, 31405, United States
SUITE 22
SAVANNAH, GA 31405
Phone: (912) 819-7878
Fax: (912) 819-3320
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 51 Open Payments records for all available years, with a total value of $939.
Total Amount is formed as General ($939) + Research ($0) + Ownership ($0) = $939.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Lilly USA, LLC ($209).
Total Amount
$939
General + Research + Ownership
Payments
51
Total payment records
General Amount
$939
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $209 |
| ABBVIE INC. | $155 |
| Novo Nordisk Inc | $95 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $65 |
| Amgen Inc. | $61 |
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: 2011-02-04
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 |
|---|---|---|---|---|
| I20110204000650 | I | Family Practice | GA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 602 | 325 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 480 | 273 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 271 | 168 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 181 | 181 | $0 |
| 83036 | Hemoglobin a1c level | 162 | 89 | $0 |
Insurance plans in this area (ZIP 31322)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | GA | |
| Family Practice | GA | |
| - | GA | |
| Internal Medicine | GA | |
| - | SC | |
| - | GA | |
| - | GA | |
| - | FL | |
| Family Practice | GA | |
| Family Practice | GA |
Reviews
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