ABIGAIL DIANE LAKE (DNP, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1730669409
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for ABIGAIL DIANE LAKE (DNP, PMHNP-BC)
8616 NORTHERN AVE
ROCKFORD, IL 611075309
Phone: (815) 399-9700
Fax: (815) 394-1401
Type: Location
2704, North Main Street, Ruby, Rockford, Winnebago County, Illinois, 61103, United States
ROCKFORD, IL 611033112
Phone: (815) 968-9300
Type: Location
1021, North Mulford Road, Rockford, Winnebago County, Illinois, 61107, United States
ROCKFORD, IL 611073877
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 94 Open Payments records for all available years, with a total value of $2,206.
Total Amount is formed as General ($2,206) + Research ($0) + Ownership ($0) = $2,206.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($285).
Total Amount
$2,206
General + Research + Ownership
Payments
94
Total payment records
General Amount
$2,206
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teva Pharmaceuticals USA, Inc. | $285 |
| Lundbeck LLC | $222 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $209 |
| IRONSHORE PHARMACEUTICALS INC. | $205 |
| ITI, Inc. | $199 |
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: 2024-01-19
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 |
|---|---|---|---|---|
| I20240119003672 | I | Nurse Practitioner | IL | 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 61107)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Clinical Psychologist | IL | |
| Clinical Social Worker | IL | |
| P S Y C H I A T R Y | IL | |
| Nurse Practitioner | IL | |
| Clinical Social Worker | IL | |
| Mental Health Counselor | IL | |
| Clinical Social Worker | IL | |
| Mental Health Counselor | IL | |
| - | IL |
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