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

Active since June 08, 2017PECOS Enrolled
35 MICHIGAN ST NE FL 2, GRAND RAPIDS, MI 49503(616) 267-1925(616) 267-1005 Get Directions Write a Review

NPPES record last updated: May 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2025, Aug 6, 2024, Jul 29, 2024 and 5 more (8 updates tracked since 2017).

About Alexander Joseph Lake Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXANDER JOSEPH LAKE DO (NPI 1255860789) is an individual pediatric hematology-oncology provider in Grand Rapids, Michigan, licensed in Michigan (5101025698) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255860789
Entity TypeIndividualMale
Primary Taxonomy2080P0207X
Provider Legal NameALEXANDER JOSEPH LAKECredential: DO
Location Address35 MICHIGAN ST NE FL 2Grand Rapids, MI 49503-2514
Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560
Phone(616) 267-1925
Fax(616) 267-1005
Sole ProprietorNo
Enumeration DateJune 8, 2017
Last NPPES UpdateMay 8, 20258 updates tracked since enumeration
NPPES CertifiedMay 8, 2025
✔ NPI 1255860789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
License✔ Licensed in MI · 5101025698
Definition
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
35 MICHIGAN ST NE FL 2, Grand Rapids, MI 49503
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexander Joseph Lake Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

DR. ALLISON MARIE CHAMPNEY SCHNEPP M.D.
Pediatrics (Pediatric Hematology-Oncology)
35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI 49503
Kent County (616) 267-1925
SHARON H SMITH MD
Pediatrics (Pediatric Hematology-Oncology)
35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI 49503
Kent County (616) 267-1925
DAVID JACOB HOOGSTRA MD
Pediatrics (Pediatric Hematology-Oncology)
35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI 49503
Kent County (616) 267-1925
ERIN E BROENE NP
Nurse Practitioner (Pediatrics)
35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI 49503
Kent County (616) 267-1924
JOSUAH CHAVEZ PA-C
Physician Assistant
35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI 49503
Kent County (616) 267-1925
KELSEY JEAN VANDERWIERE CPNP-AC
Nurse Practitioner (Pediatrics)
35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI 49503
Kent County (616) 267-1925
DR. ULRICH ANDREAS DUFFNER M.D.
Pediatrics (Pediatric Hematology-Oncology)
35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI 49503
Kent County (616) 267-1925
MIKAYLA ELIZABETH PATEL MD
Pediatrics
35 MICHIGAN ST NE FL 2
GRAND RAPIDS, MI 49503
Kent County (616) 267-1925

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 Alexander Lake's NPI number?

The NPI number for Alexander Lake is 1255860789. It was assigned to this individual provider in the NPPES registry on June 8, 2017.

Where is Alexander Lake located?

Alexander Lake practices at 35 Michigan St NE Fl 2, Grand Rapids, MI 49503. The listed phone number is (616) 267-1925.

What is Alexander Lake's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Is Alexander Lake enrolled in Medicare?

Yes. Alexander Lake is registered in the Medicare PECOS enrollment system.

What insurance does Alexander Lake accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Priority Health list Alexander Lake as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Alexander Lake was last updated on May 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.