EDWARD LAKE MD
NPI 1336131101
Internal Medicine - Nephrology in Oshkosh, WI

Q: What is Edward Lake's NPI number?

The NPI number for Edward Lake is 1336131101. It was assigned to this individual provider in the NPPES registry on August 18, 2005.

Q: What is Edward Lake's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Edward Lake was last updated on October 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since August 18, 2005PECOS EnrolledAccepts Medicare Assignment

855 N WESTHAVEN DR, OSHKOSH, WI 54904(920) 303-5626(920) 303-5632 Get Directions Write a Review

NPPES record last updated: October 31, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Oct 31, 2023, Nov 22, 2021 (2 updates tracked since 2021).

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About Edward Lake Md NPPES

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

EDWARD LAKE MD (NPI 1336131101) is an individual nephrology provider in Oshkosh, Wisconsin, licensed in Wisconsin (29465) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Oshkosh, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1987).

NPPES Registry Identity

NPI1336131101

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameEDWARD LAKECredential: MD

Location Address855 N WESTHAVEN DROshkosh, WI 54904-7668

Mailing AddressPo Box 735044Chicago, IL 60673-5044

Phone(920) 303-5626

Fax(920) 303-5632

Sole ProprietorNo

Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1987

Enumeration DateAugust 18, 2005

Last NPPES UpdateOctober 31, 20232 updates tracked since enumeration

NPPES CertifiedOctober 31, 2023

✔ NPI 1336131101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in WI · 29465

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

855 N WESTHAVEN DR, Oshkosh, WI 54904

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Other Identifiers 1

Medicaid31925100WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) 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 and accepts Medicare assignment

Edward Lake Md 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.

PECOS PAC ID1557260619

PECOS Enrollment IDI20040113000426

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.

Areas of Expertise CMS Part B claims 9

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.

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

155 services21 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

120 services42 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

77 services59 patients

Manual urinalysis test with examination using microscope, non-automated 81000

A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.

73 services62 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

35 services31 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

33 services30 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Aurora Medical Ctr Oshkosh

Acute Care Hospitals · Oshkosh, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520198

Location855 N Westhaven DriveOshkosh, WI 54904 · Winnebago County

Emergency services Birthing friendly

Berlin Memorial Hospital

Critical Access Hospitals · Berlin, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521355

Location225 Memorial DriveBerlin, WI 54923 · Green Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54904 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Mycophenolic acid, oral, 180 mg J7518

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers14 claims2,880 services$1.00 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

2 suppliers19 claims19 services$12.02 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

JACQUELINE ANN OTS PENDING

Nurse Practitioner