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LACEY DARLENE LAKE FOREMAN CRNP
NPI 1922510635
Nurse Practitioner in Golden Valley, MN

Active since November 03, 2017PECOS Enrolled
820 LILAC DR N STE 210, GOLDEN VALLEY, MN 55422(763) 205-3600 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 9, 2025, Nov 3, 2017 (2 updates tracked since 2017).

About Lacey Darlene Lake Foreman Crnp NPPES

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

LACEY DARLENE LAKE FOREMAN CRNP (NPI 1922510635) is an individual nurse practitioner in Golden Valley, Minnesota, licensed in Minnesota (13651) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Eau Claire, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1922510635
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameLACEY DARLENE LAKE FOREMANCredential: CRNP
Location Address820 LILAC DR N STE 210Golden Valley, MN 55422-4754
Mailing Address2843 State Route 31Acme, PA 15610-1371 · (724) 875-7632
Phone(763) 205-3600
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 3, 2017
Last NPPES UpdateDecember 9, 20252 updates tracked since enumeration
NPPES CertifiedDecember 9, 2025
✔ NPI 1922510635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in MN · 13651✔ Licensed in WI · 17742-33✔ Licensed in PA · SP018060
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
820 LILAC DR N STE 210, Golden Valley, MN 55422
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Other Names 1

Former Name (1)Lacey Darlene Lake

Secondary Practice Location 1

Location 12263 Eastridge CtrEau Claire, WI 54701-3410 · Phone (715) 800-0900

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lacey Darlene Lake Foreman Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2860750528
PECOS Enrollment IDI20250409000112
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.

Medicare Billing Reassignment

Medicare enrollment records show Lacey Lake Foreman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ars Treatment Centers, P.C.
778 mi
Multi-Specialty
104 DELAWARE AVE STE 244
Uniontown, PA 15401
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Ars Treatment Centers PC
  • 140 clinicians in this Medicare group
NPI 1346731171 (800) 805-6989

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55422 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSEPH R SPURLOCK MD
Family Medicine (Hospice and Palliative Medicine)
820 LILAC DR N STE 210
GOLDEN VALLEY, MN 55422
Hennepin County (763) 205-3600
MRS. NICOLE MARIE BURROWS FNP
Nurse Practitioner (Family)
820 LILAC DR N STE 210
GOLDEN VALLEY, MN 55422
Hennepin County (763) 205-3600
MOMENTS PALLIATIVE CARE LLC
Family Medicine (Geriatric Medicine)
820 LILAC DR N STE 210
GOLDEN VALLEY, MN 55422
Hennepin County (763) 205-3600

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 Lacey Lake Foreman's NPI number?

The NPI number for Lacey Lake Foreman is 1922510635. It was assigned to this individual provider in the NPPES registry on November 3, 2017. The provider is also known as Lacey Darlene Lake.

Where is Lacey Lake Foreman located?

Lacey Lake Foreman practices at 820 Lilac Dr N Ste 210, Golden Valley, MN 55422. The listed phone number is (763) 205-3600.

What is Lacey Lake Foreman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lacey Lake Foreman enrolled in Medicare?

Yes. Lacey Lake Foreman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lacey Lake Foreman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lacey Lake Foreman reassigns Medicare benefits to Ars Treatment Centers, P.C. (Uniontown, PA). The 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 Lacey Lake Foreman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lacey Lake Foreman was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.