COURTNEY MARIE LAKE NP
NPI 1770812257
Nurse Practitioner - Acute Care in Forest Hills, NY

Active since December 14, 2009PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
10201 66TH RD, FOREST HILLS, NY 11375(718) 830-4000 Get Directions Write a Review

NPPES record last updated: February 16, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 16, 2023, Dec 9, 2022 (2 updates tracked since 2022).

About Courtney Marie Lake Np NPPES

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

COURTNEY MARIE LAKE NP (NPI 1770812257) is an individual acute care provider in Forest Hills, New York, licensed in New York (F432374) and active in the NPI registry since December 2009. She is enrolled in Medicare PECOS, is affiliated with Peconic Bay Medical Center, and maintains a secondary practice location in Williamsville.

NPPES Registry Identity

NPI1770812257
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameCOURTNEY MARIE LAKECredential: NP
Location Address10201 66TH RDForest Hills, NY 11375-2029
Mailing Address8 Chatham Woods DrCentereach, NY 11720-4029 · (716) 523-3993
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateDecember 14, 2009
Last NPPES UpdateFebruary 16, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 16, 2023
NPI 1770812257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License Licensed in NY · F432374
Also ListedRegistered NurseTaxonomy 163W00000X · License 621543 (NY)
10201 66TH RD, Forest Hills, NY 11375

Secondary Practice Location 1

Location 12250 Wehrle Dr, Suite 1Williamsville, NY 14221-7034 · Phone (716) 276-2123 · Fax (716) 276-2129

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

Courtney Marie Lake Np 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 ID1355719881
PECOS Enrollment IDI20221115000634
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.

Hospital Affiliations CMS Care Compare 2

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

Peconic Bay Medical Center

Acute Care Hospitals · Riverhead, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number330107
Location1 Heros WayRiverhead, NY 11901 · Suffolk County
Emergency services Birthing friendly

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number330393
LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11375 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
$104.17 typical visit price
range $67.00 – $201.98
Typical copayment $26.04 (range $16.75 – $50.49)
Most-billed visit code 99203
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

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.

Student in an Organized Health Care Education/Training Program
10201 66TH RD
FOREST HILLS, NY 11375
Specialist
10201 66TH RD
FOREST HILLS, NY 11375
Internal Medicine (Critical Care Medicine)
10201 66TH RD
FOREST HILLS, NY 11375
Surgery (Vascular Surgery)
10201 66TH RD
FOREST HILLS, NY 11375
Emergency Medicine
10201 66TH RD, MEDICAL STAFF OFFICE
FOREST HILLS, NY 11375
Student in an Organized Health Care Education/Training Program
10201 66TH RD
FOREST HILLS, NY 11375
Student in an Organized Health Care Education/Training Program
10201 66TH RD
FOREST HILLS, NY 11375
Radiology (Diagnostic Radiology)
10201 66TH RD, RADIOLOGY DEPARTMENT
FOREST HILLS, NY 11375

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 Courtney Lake's NPI number?

The NPI number for Courtney Lake is 1770812257. It was assigned to this individual provider in the NPPES registry on December 14, 2009.

Where is Courtney Lake located?

Courtney Lake practices at 10201 66th Rd, Forest Hills, NY 11375. The listed phone number is (718) 830-4000.

What is Courtney Lake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Courtney Lake enrolled in Medicare?

Yes. Courtney 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.

Is Courtney Lake affiliated with any hospitals?

According to CMS data, Courtney Lake is affiliated with Peconic Bay Medical Center and Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for Courtney Lake was last updated on February 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.