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ABIGAIL DIANE LAKE DNP, PMHNP-BC
NPI 1730669409
Nurse Practitioner - Psychiatric/Mental Health in Rockford, IL

Active since August 21, 2018PECOS EnrolledAccepts Medicare Assignment
8616 NORTHERN AVE, ROCKFORD, IL 61107(815) 399-9700(815) 394-1401 Get Directions Write a Review

NPPES record last updated: October 23, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 23, 2023, Aug 21, 2018 (2 updates tracked since 2018).

About Abigail Diane Lake Dnp, Pmhnp-bc NPPES

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

ABIGAIL DIANE LAKE DNP, PMHNP-BC (NPI 1730669409) is an individual psychiatric/mental health provider in Rockford, Illinois, licensed in Illinois (209.028520) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1730669409
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameABIGAIL DIANE LAKECredential: DNP, PMHNP-BC
Location Address8616 NORTHERN AVERockford, IL 61107-5309
Mailing Address1021 N Mulford RdRockford, IL 61107-3877
Phone(815) 399-9700
Fax(815) 394-1401
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 21, 2018
Last NPPES UpdateOctober 23, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2023
✔ NPI 1730669409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in IL · 209.028520
Also ListedRegistered Nurse · Addiction (Substance Use Disorder)Taxonomy 163WA0400X · License 041404632 (IL)
8616 NORTHERN AVE, Rockford, IL 61107
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MercyCare Health Plans, Providence Health Plan, Quartz.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

Abigail Diane Lake Dnp, Pmhnp-bc 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 ID6204288798
PECOS Enrollment IDI20240119003672
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61107 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

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.

HOLLY BRUN
Counselor
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003
MR. JACOB R WILSON BA
Counselor (Mental Health)
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 391-1000
SEAN WALSH LPC
Counselor (Professional)
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003
DEBRA CORRIGAN APN
Nurse Practitioner (Psychiatric/Mental Health)
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 399-9700
JACQUELINE BELTER
Counselor
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003
ALICIA ANDERSON L.S.W.
Social Worker
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 338-8003
CHRISTINA ADAMS
Counselor
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003
MELISSA LEE
Counselor
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003

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 Abigail Lake's NPI number?

The NPI number for Abigail Lake is 1730669409. It was assigned to this individual provider in the NPPES registry on August 21, 2018.

Where is Abigail Lake located?

Abigail Lake practices at 8616 Northern Ave, Rockford, IL 61107. The listed phone number is (815) 399-9700.

What is Abigail Lake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Abigail Lake enrolled in Medicare?

Yes. Abigail Lake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Abigail Lake accept?

Health plans from MercyCare Health Plans, Providence Health Plan and Quartz list Abigail 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 Abigail Lake was last updated on October 23, 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.