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LAKE OBSTETRICS AND GYNECOLOGY, INC
NPI 1811950447
Obstetrics & Gynecology in Mentor, OH

Active since April 06, 2006CLIA 36D2327840 · Microscopy
8300 TYLER BLVD STE 300, MENTOR, OH 44060(440) 557-7100 Get Directions Write a Review

NPPES record last updated: August 7, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 7, 2025, Jul 29, 2020 (2 updates tracked since 2020).

About Lake Obstetrics And Gynecology, Inc NPPES

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

LAKE OBSTETRICS AND GYNECOLOGY, INC (NPI 1811950447) is a healthcare organization registered as an obstetrics & gynecology in Mentor, Ohio and active in the NPI registry since April 2006. The organization holds a CLIA Microscopy certificate valid through July 29, 2027, maintains 3 additional practice locations, and lists Susanna Bowman, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1811950447
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameLAKE OBSTETRICS AND GYNECOLOGY, INC
Location Address8300 TYLER BLVD STE 300Mentor, OH 44060-4251
Mailing Address8300 Tyler Blvd Ste 300Mentor, OH 44060-4251 · (440) 357-7100 · Fax (440) 357-8136
Phone(440) 557-7100
Organization SubpartNo
Authorized OfficialSusanna BowmanOffice Manager · (440) 357-7100
Enumeration DateApril 6, 2006
Last NPPES UpdateAugust 7, 20252 updates tracked since enumeration
NPPES CertifiedAugust 7, 2025
✔ NPI 1811950447 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
8300 TYLER BLVD STE 300, Mentor, OH 44060
Open in Google Maps ↗

Secondary Practice Locations 3

Location 19500 Mentor AveMentor, OH 44060-8713 · Phone (440) 357-7100 · Fax (440) 357-8132
Location 27580 Auburn Rd Ste 313Concord Twp, OH 44077-9618 · Phone (440) 352-0688 · Fax (440) 352-3724
Location 36270 N Ridge RdMadison, OH 44057-2567 · Phone (440) 357-7100 · Fax (440) 357-8132

Other Identifiers 1

Medicaid0890175OH

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

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lake Obstetrics And Gynecology, 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 Lake Obstetrics And Gynecology, Inc, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Alyssa Bledsoe, APRN-CNM
Certified Nurse Midwife (CNM)
NPI 1073322277
8300 TYLER BLVD STE 300
Mentor, OH 44060
(440) 357-7100
✔ PECOS✔ Accepts MedicareSame address
Rosemary Brownlee, MD
Obstetrics/Gynecology
NPI 1700842812
8300 TYLER BLVD STE 300
Mentor, OH 44060
(440) 357-7100
✔ PECOS✔ Accepts MedicareSame address
Kristen Eichorn, MD
Obstetrics/Gynecology
NPI 1750709150
8300 TYLER BLVD STE 300
Mentor, OH 44060
(440) 357-7100
✔ PECOS✔ Accepts MedicareSame address
Abigail Tucker, MD
Obstetrics/Gynecology
NPI 1043229503
8300 TYLER BLVD STE 300
Mentor, OH 44060
(440) 357-7100
✔ PECOS✔ Accepts MedicareSame address
Jennifer Velotta, M.D.
Obstetrics/Gynecology
NPI 1003000423
8300 TYLER BLVD STE 300
Mentor, OH 44060
(440) 357-7100
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 36D2327840

Lake Obstetrics & Gynecology, Inc · Mentor, OH
Active · expires Jul 29, 2027
CLIA Number36D2327840
Laboratory TypePhysician Office
Certificate Effective DateJuly 30, 2025
Certificate Expiration DateJuly 29, 2027
Laboratory DirectorJennifer A. Velotta
Laboratory Phone(440) 357-7100
Laboratory LocationLake Obstetrics & Gynecology, Inc8300 Tyler Blvd, Suite 300, Mentor, OH 44060
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Lake Obstetrics And Gynecology, Inc's NPI number?

The NPI number for Lake Obstetrics And Gynecology, Inc is 1811950447. It was assigned to this organization in the NPPES registry on April 6, 2006.

Where is Lake Obstetrics And Gynecology, Inc located?

Lake Obstetrics And Gynecology, Inc is located at 8300 Tyler Blvd Ste 300, Mentor, OH 44060. The listed phone number is (440) 557-7100.

What is Lake Obstetrics And Gynecology, Inc's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Lake Obstetrics And Gynecology, Inc enrolled in Medicare?

Yes. Lake Obstetrics And Gynecology, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Obstetrics And Gynecology, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Lake Obstetrics And Gynecology, 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 Obstetrics/Gynecology (4) and Certified Nurse Midwife (CNM) (1). Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lake Obstetrics And Gynecology, Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 36D2327840) is associated with this NPI, valid through July 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Obstetrics And Gynecology, Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Lake Obstetrics And Gynecology, Inc 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 Lake Obstetrics And Gynecology, Inc was last updated on August 7, 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.