KENNETH B LAKE CRNA
NPI 1003964024
Nurse Anesthetist, Certified Registered in Delta, CO
About Kenneth B Lake Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH B LAKE CRNA (NPI 1003964024) is an individual nurse anesthetist, certified registered in Delta, Colorado, licensed in Colorado (APN.0997653-CRNA) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Kaiser Permanente School Of Medicine (2005).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kenneth B Lake Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kenneth Lake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Delta, CO 81416
- Reassigned Medicare billing, Colorado enrollment
- 111 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 81416 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenneth Lake's NPI number?
The NPI number for Kenneth Lake is 1003964024. It was assigned to this individual provider in the NPPES registry on January 8, 2007.
Where is Kenneth Lake located?
Kenneth Lake practices at 1501 E 3rd St, Delta, CO 81416. The listed phone number is (970) 874-7681.
What is Kenneth Lake's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Kenneth Lake enrolled in Medicare?
Yes. Kenneth Lake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kenneth Lake's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Lake reassigns Medicare benefits to Delta County Memorial Hospital (Delta, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Lake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kenneth Lake was last updated on June 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kenneth B Lake, CRNA · NPI 1003964024
Nurse Anesthetist, Certified Registered physician in Delta, Colorado. Individual provider, active in the CMS NPPES registry since January 8, 2007.
## Identity
- **NPI:** 1003964024 (Entity type: Individual)
- **Enumerated:** January 8, 2007
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** APN.0997653-CRNA (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 1501 E 3RD ST, Delta, CO 81416-2815
- **Phone:** (970) 874-7681
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** Delta County Memorial Hospital (NPI 1114180817, Delta, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Kaiser Permanente School Of Medicine, class of 2005
## Record status
- **NPPES last updated:** June 5, 2026
- **Other identifiers:** Medicaid 9000203100 (CO)
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Source: [NPI Profile](https://npiprofile.com/npi/1003964024) · Data from the CMS NPPES public registry.