JASON EDWARD LAKE (MD) – Orthopaedic Foot and Ankle Surgery Physician, NPI 1205051430
Orthopaedic Foot and Ankle Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
662 ORTHOPEDIC SURGERY in AZ
Provider Addresses for JASON EDWARD LAKE (MD)
PO BOX 271429
SALT LAKE CITY, UT 841271429
Phone: (480) 964-2908
Fax: (480) 833-2136
Type: Mailing
2940 E BANNER GATEWAY DR
SUITE 200
GILBERT, AZ 852342171
Phone: (480) 964-2908
Fax: (480) 833-2136
Type: Location
1675 E Melrose St Ste 101-103
Gilbert, AZ 852971001
Phone: (602) 648-5444
Fax: (602) 772-3801
Type: Location
2940 E BANNER GATEWAY DR STE 200-250
GILBERT, AZ 852342168
Phone: (480) 964-2908
Fax: (480) 833-2136
Type: Location
PO BOX 80217
PHOENIX, AZ 850600217
Phone: (602) 385-2115
Fax: (480) 418-3323
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 99 Open Payments records for all available years, with a total value of $11,260.
Total Amount is formed as General ($11,260) + Research ($0) + Ownership ($0) = $11,260.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Smith+Nephew, Inc. ($8,408).
Total Amount
$11,260
General + Research + Ownership
Payments
99
Total payment records
General Amount
$11,260
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $8,408 |
| Stryker Corporation | $2,251 |
| Orthofix Medical, Inc. | $196 |
| Abbott Laboratories | $179 |
| TREACE MEDICAL CONCEPTS, INC. | $140 |
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: 2010-09-22
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 |
|---|---|---|---|---|
| I20100922000579 | I | Orthopedic Surgery | AZ | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 600 | 331 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 448 | 253 | $0 |
| 73610 | X-ray of ankle, minimum of 3 views | 296 | 160 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 270 | 205 | $0 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 150 | 91 | $0 |
Insurance plans in this area (ZIP 84127)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ORTHOPEDIC SURGERY | AZ | 73630 | X-ray of foot, minimum of 3 views | 230 | 151 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | AZ | |
| Physician Assistant | AZ | |
| Physical Therapist In Private Practice | AZ | |
| Orthopedic Surgery | UT | |
| Physician Assistant | AZ | |
| Physical Therapist In Private Practice | MT | |
| Physical Therapist In Private Practice | IL | |
| - | AZ | |
| - | AZ | |
| Physical Therapist In Private Practice | UT |
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