ALEXANDER JOSEPH LAKE DO
NPI 1255860789
Pediatrics - Pediatric Hematology-Oncology in Grand Rapids, MI

NPI Status: Active since June 08, 2017

Contact Information

35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 267-1925
Fax: (616) 267-1005

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Pediatrics
Pediatric Hematology-Oncology
Accepts Insurance
PECOS Enrolled

About ALEXANDER LAKE

This page provides the complete NPI Profile along with additional information for Alexander Lake, a pediatrician established in Grand Rapids, Michigan with a medical specialization in Pediatrics, focusing in pediatric hematology-oncology . The healthcare provider is registered in the NPI registry with number 1255860789 assigned on June 2017. The practitioner's primary taxonomy code is 2080P0207X with license number 5101025698 (MI). The provider is registered as an individual and his NPI record was last updated May 2025.

NPI: 1255860789
Provider Name: ALEXANDER JOSEPH LAKE DO
Gender: Male
Entity Type: Individual
Location Address: 35 MICHIGAN ST NE FL 2 GRAND RAPIDS, MI 49503
Location Phone: (616) 267-1925
Location Fax: (616) 267-1005
Mailing Address: 100 MICHIGAN ST NE # MC845 GRAND RAPIDS, MI 49503
Is Sole Proprietor?: No
Enumeration Date: 06-08-2017
Last Update Date: 05-08-2025
Code Navigator

A pediatrician like Alexander Lake is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Pediatrics Pediatric Hematology-Oncology
Taxonomy Code: 2080P0207X
Type: Allopathic & Osteopathic Physicians
License No.: 5101025698
License State: MI
Taxonomy Description: A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

McLaren Health Plan Community

MHP Bronze - HMO
MHP Bronze Saver (Expanded) - HMO
MHP Expanded Bronze Standard - HMO
MHP Gold - HMO
MHP Gold Standard - HMO
MHP Silver Exchange - HMO
MHP Silver Exchange Rewards - HMO
MHP Silver Standard - HMO
MHP Young Adult/Catastrophic - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Alexander Lake is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	2	5	5	8	6	0	7	8	9
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	10	5	16	6	0	7	16
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 0 + 5 + 1 + 6 + 6 + 0 + 7 + 1 + 6 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 9									9

The NPI number 1255860789 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

DR. ALLISON MARIE CHAMPNEY SCHNEPP M.D.

Pediatrics

(Pediatric Hematology-Oncology)

35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI
ZIP 49503

About ALEXANDER LAKE

Location Map

Specialty - Primary Taxonomy

Pediatrics Pediatric Hematology-Oncology

Insurance Plans Accepted

McLaren Health Plan Community

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Reviews for ALEXANDER JOSEPH LAKE DO

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions

What is Alexander Lake's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does Alexander Lake accept?