JOHN T LAKE (M.D.) – Psychiatry Physician, NPI 1629270194

JOHN T LAKE (M.D.) is a healthcare provider. based in Cape girardeau, Missouri. specializing in PSYCHIATRY. They hold the professional credentials M.D.. They hold a License No. 108382 (MO). The NPI Number for JOHN T LAKE (M.D.) is 1629270194

Main info

Male
Sole Proprietor
31 Years Of Experience
Accepts Medicare Assignment
Name
JOHN T LAKE (M.D.)
NPI
1629270194
Phone
(573) 519-4949
Address
60 DOCTORS PARK LOWR LEVEL
Enumeration Date
5 June 2007
Last Update Date
1 August 2018

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5735453700
Graduation Year
1995 (31 years ago)
PAC ID
2567621196
Group Practice PAC ID
1355252891
Professional Enrollment ID
I20120316000481
Address ID
MO637368237BE6468X77XX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

819 PSYCHIATRY in MO

Provider Addresses for JOHN T LAKE (M.D.)

  • 60 DOCTORS PARK LOWR LEVEL

    CAPE GIRARDEAU, MO 637034928

    Phone: (573) 519-4949

    Fax: (573) 519-4665

    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 16 Open Payments records for all available years, with a total value of $327.

Total Amount is formed as General ($327) + Research ($0) + Ownership ($0) = $327.

Last reported payment date: 2024-10-30 • Largest payer in this snapshot: Axsome Therapeutics, Inc. ($90).

Total Amount

$327

General + Research + Ownership

Payments

16

Total payment records

General Amount

$327

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-30

Latest reported date

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: 2012-03-16

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
I20120316000481IPsychiatryMOTBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes23070$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes17767$0
90792Psychiatric diagnostic evaluation with medical services6461$0
99239Hospital discharge day management, more than 30 minutes5550$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes3834$0
View full utilization report →

Insurance plans in this area (ZIP 63703)

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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: 1355252891View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Certified Registered Nurse Anesthetist (Crna)AR
Physician AssistantMO
Nurse PractitionerMO
Nurse PractitionerMO
Endocrinology, Internal MedicineMO
Family PracticeMO
General SurgeryMO

Reviews

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Frequently asked questions

How is JOHN T LAKE (M.D.) identified in CMS data?
CMS-hosted NPPES data lists JOHN T LAKE (M.D.) with NPI 1629270194.
Does CMS list JOHN T LAKE (M.D.) as active?
Yes — JOHN T LAKE (M.D.) is active in the NPI listing used on this page.
What is JOHN T LAKE (M.D.) best known for clinically?
Directory data describes JOHN T LAKE (M.D.) with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where should I expect JOHN T LAKE (M.D.) on a map?
Expect Cape Girardeau, Missouri as a primary anchor for JOHN T LAKE (M.D.) unless the record lists multiple sites.
Why does JOHN T LAKE (M.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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