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JEFFREY P. LAKE, M.D., INC.
NPI 1639487002
Colon & Rectal Surgery in Encino, CA

Active since September 20, 2010
16311 VENTURA BLVD, SUITE 505, ENCINO, CA 91436(818) 387-8725 Get Directions Write a Review

NPPES record last updated: November 16, 2010. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jeffrey P. Lake, M.d., Inc. NPPES

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

JEFFREY P. LAKE, M.D., INC. (NPI 1639487002) is a healthcare organization registered as a colon & rectal surgery in Encino, California and active in the NPI registry since September 2010. The organization lists Jeffrey Lake, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1639487002
Entity TypeOrganization
Primary Taxonomy208C00000X
Legal Business NameJEFFREY P. LAKE, M.D., INC.
Location Address16311 VENTURA BLVD, SUITE 505Encino, CA 91436-2124
Mailing Address16311 Ventura Blvd, Suite 505Encino, CA 91436-2124 · (818) 387-8725
Phone(818) 387-8725
Organization SubpartNo
Authorized OfficialJeffrey LakePhysician/owner · (818) 387-8725
Enumeration DateSeptember 20, 2010
Last NPPES UpdateNovember 16, 2010
✔ NPI 1639487002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in CA · A73315
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
16311 VENTURA BLVD, Encino, CA 91436
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Other Identifiers 2

OtherWA73315AMedicare Ppin
Medicare UPINW18801

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffrey P. Lake, M.d., Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Jeffrey P. Lake, M.D., Inc., which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Meghana Kashyap, MD
Colorectal Surgery (Proctology)
NPI 1386096360
16311 VENTURA BLVD STE 505
Encino, CA 91436
(818) 387-8725
✔ PECOS✔ Accepts MedicareSame address
Jeffrey Lake, M.D.
Colorectal Surgery (Proctology)
NPI 1326006024
16311 VENTURA BLVD SUITE 505
Encino, CA 91436
(818) 645-5920
✔ PECOS✔ Accepts MedicareSame address
Daniel Gingold, MD
Colorectal Surgery (Proctology)
NPI 1376834309
16311 VENTURA BLVD STE 505
Encino, CA 91436
(818) 387-8725
✔ PECOS✔ Accepts MedicareSame address
Vemuru Sunil Reddy, MD
Colorectal Surgery (Proctology)
NPI 1639451578
16311 VENTURA BLVD STE 505
Encino, CA 91436
(818) 387-8725
✔ PECOS✔ Accepts MedicareSame address
Charles Headrick, MD
General Surgery
NPI 1265537831
5525 ETIWANDA AVE #201
Tarzana, CA 91356
(818) 996-8505
✔ PECOS✔ Accepts Medicare2.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Jeffrey P. Lake, M.D., Inc.'s NPI number?

The NPI number for Jeffrey P. Lake, M.D., Inc. is 1639487002. It was assigned to this organization in the NPPES registry on September 20, 2010.

Where is Jeffrey P. Lake, M.D., Inc. located?

Jeffrey P. Lake, M.D., Inc. is located at 16311 Ventura Blvd Suite 505, Encino, CA 91436. The listed phone number is (818) 387-8725.

What is Jeffrey P. Lake, M.D., Inc.'s specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Jeffrey P. Lake, M.D., Inc. enrolled in Medicare?

Yes. Jeffrey P. Lake, M.D., Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jeffrey P. Lake, M.D., Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Jeffrey P. Lake, M.D., Inc.. A 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 the clinician's services. The largest specialties are Colorectal Surgery (Proctology) (4) and General Surgery (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jeffrey P. Lake, M.D., Inc. was last updated on November 16, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.