MICHELLE LAKE – Acute Care Nurse Practitioner, NPI 1033838826
Acute Care Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MICHELLE LAKE
11 WESTWOOD DR
GENESEO, IL 612549584
Phone: (309) 507-2367
Type: Mailing
530 NE GLEN OAK AVE
PEORIA, IL 616370001
Phone: (309) 655-2000
Type: Location
1236 E RUSHOLME ST STE 300
DAVENPORT, IA 528032484
Phone: (800) 382-0707
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 28 Open Payments records for all available years, with a total value of $514.
Total Amount is formed as General ($514) + Research ($0) + Ownership ($0) = $514.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ABIOMED ($294).
Total Amount
$514
General + Research + Ownership
Payments
28
Total payment records
General Amount
$514
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABIOMED | $294 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $104 |
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | $103 |
| Abbott Laboratories | $13 |
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: 2023-08-02
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 |
|---|---|---|---|---|
| I20230802003296 | I | Nurse Practitioner | IA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61254)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | IA | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Pediatric Medicine | IA | |
| Nurse Practitioner | IL | |
| Internal Medicine | IL | |
| Nurse Practitioner | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | IA | |
| Nurse Practitioner | IA | |
| Cardiac Electrophysiology, Interventional Cardiology, Cardiovascular Disease (Cardiology) | IA | |
| Nurse Practitioner | IA | |
| Nurse Practitioner | IL |
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