JENNIFER A LAKE (MD) – Family Medicine Physician, NPI 1245205301

JENNIFER A LAKE (MD) is a healthcare provider. based in White bear lake, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 44657 (MN). The NPI Number for JENNIFER A LAKE (MD) is 1245205301

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER A LAKE (MD)
NPI
1245205301
Phone
(651) 287-8780
Address
4422 WHITE BEAR AVE N
Enumeration Date
22 February 2006
Last Update Date
8 December 2015

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
-
Graduation Year
2001 (25 years ago)
PAC ID
8628052099
Group Practice PAC ID
2466631593
Professional Enrollment ID
I20040614001551
Address ID
MN551103475Wh4422XNXXX500
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,075 FAMILY PRACTICE in MN

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Provider Addresses for JENNIFER A LAKE (MD)

  • White Bear Avenue, White Bear Lake, Ramsey County, Minnesota, 55109, United States

    WHITE BEAR LAKE, MN 551103475

    Phone: (651) 287-8780

    Fax: (651) 287-8786

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2024-07-31 • Largest payer in this snapshot: Lilly USA, LLC ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-31

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Lilly USA, LLC$19
View all Open Payments →|Open Payments Risk Radar →

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: 2004-06-14

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040614001551IFamily PracticeMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes11265$0
99213Established patient office or other outpatient visit, 20-29 minutes5336$0
81003Automated urinalysis test4735$0
99215Established patient office or other outpatient visit, 40-54 minutes1514$0
View full utilization report →

Insurance plans in this area (ZIP 55110)

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Provider's Procedures

JENNIFER A LAKE (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMN81002Urinalysis, manual test1915

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466631593View full group profile
NameSpecialtyState
Nurse PractitionerMN
Nurse PractitionerNH
Nurse PractitionerMN
Nurse PractitionerOH
Family PracticeMN

Reviews

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Frequently asked questions

Does JENNIFER A LAKE (MD) have a public NPI I can cite?
Public records show JENNIFER A LAKE (MD) under NPI 1245205301.
Is JENNIFER A LAKE (MD)'s NPI status active today?
Active status means JENNIFER A LAKE (MD)'s NPI record is not deactivated in the public file.
What services align with JENNIFER A LAKE (MD)'s listing?
JENNIFER A LAKE (MD)'s public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Can patients visit JENNIFER A LAKE (MD) in White Bear Lake, Minnesota?
For routing, start with White Bear Lake, Minnesota for JENNIFER A LAKE (MD), then verify phone and hours locally.
Why is information missing for JENNIFER A LAKE (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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