DR. RUSSELL STEVEN LAKE (O.D.) – Optometrist, NPI 1720603392

DR. RUSSELL STEVEN LAKE (O.D.) is a healthcare provider. based in East wenatchee, Washington. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 61042825 (WA). The NPI Number for DR. RUSSELL STEVEN LAKE (O.D.) is 1720603392

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. RUSSELL STEVEN LAKE (O.D.)
NPI
1720603392
Phone
(509) 886-0924
Address
375 HIGHLINE DR
Enumeration Date
10 June 2020
Last Update Date
10 June 2020

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
5097661880
Graduation Year
2019 (7 years ago)
PAC ID
9739534348
Group Practice PAC ID
7719313790
Professional Enrollment ID
I20231017000336
Address ID
WA988375902MO845XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,098 OPTOMETRY in WA

Provider Addresses for DR. RUSSELL STEVEN LAKE (O.D.)

  • 375 HIGHLINE DR

    EAST WENATCHEE, WA 988025344

    Phone: (509) 886-0924

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-10-17

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
I20231017000336IOptometryWATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98802)

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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: 7719313790View full group profile
NameSpecialtyState
-WA
O P T O M E T R YWA
O P T O M E T R YWA
O P T O M E T R YWA

Reviews

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Frequently asked questions

What federal number belongs to DR. RUSSELL STEVEN LAKE (O.D.)?
The federal identifier for DR. RUSSELL STEVEN LAKE (O.D.) is NPI 1720603392.
Is DR. RUSSELL STEVEN LAKE (O.D.) currently active in the NPI registry?
CMS-published data lists DR. RUSSELL STEVEN LAKE (O.D.) as an active registrant.
Does DR. RUSSELL STEVEN LAKE (O.D.) list a primary specialty?
If you are matching referrals, note Optometrist for DR. RUSSELL STEVEN LAKE (O.D.). Clinical services aligned with this taxonomy classification.
Where does public data place DR. RUSSELL STEVEN LAKE (O.D.)?
The snapshot lists East Wenatchee, Washington for DR. RUSSELL STEVEN LAKE (O.D.); download NPPES for the complete set.
Is DR. RUSSELL STEVEN LAKE (O.D.) a real provider?
This page reflects official NPPES data for NPI 1720603392. Always confirm identity and privileges with the practice and licensing boards.

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