KATHERINE HAILEY LAKE OTR/L
NPI 1023624483
Occupational Therapist in Roseville, MN
About Katherine Hailey Lake Otr/l NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHERINE HAILEY LAKE OTR/L (NPI 1023624483) is an individual occupational therapist in Roseville, Minnesota, licensed in Minnesota (107723) and active in the NPI registry since September 2020.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Katherine Hailey Lake Otr/l is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Katherine Lake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Roseville, MN 55113
- Reassigned Medicare billing, Minnesota enrollment
- 89 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.
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROSEVILLE, MN 55113
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 Katherine Lake's NPI number?
The NPI number for Katherine Lake is 1023624483. It was assigned to this individual provider in the NPPES registry on September 21, 2020.
Where is Katherine Lake located?
Katherine Lake practices at 1835 County Road C W, Roseville, MN 55113. The listed phone number is (651) 638-0080.
What is Katherine Lake's specialty?
The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.
Is Katherine Lake enrolled in Medicare?
Yes. Katherine Lake is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Katherine Lake's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Katherine Lake reassigns Medicare benefits to Novacare Outpatient Rehabilitation East, Inc. (Roseville, MN). 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 Katherine 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 Katherine Lake was last updated on March 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.