JACK RUSSELLE LAKE D.O.
NPI 1932248101
Radiology - Diagnostic Radiology in Albany, GA

Q: What is Jack Lake's NPI number?

The NPI number for Jack Lake is 1932248101. It was assigned to this individual provider in the NPPES registry on February 5, 2007.

Q: What is Jack Lake's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Jack Lake was last updated on October 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.

Active since February 05, 2007PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

2624 DAWSON RD, ALBANY, GA 31707(229) 888-1624 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Jack Russelle Lake D.o. NPPES

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

JACK RUSSELLE LAKE D.O. (NPI 1932248101) is an individual diagnostic radiology provider in Albany, Georgia, licensed in Oklahoma (4205) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Oklahoma City, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1932248101

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameJACK RUSSELLE LAKECredential: D.O.

Location Address2624 DAWSON RDAlbany, GA 31707-1609

Mailing Address700 E Morehead St Ste 300Charlotte, NC 28202-2742

Phone(229) 888-1624

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateFebruary 5, 2007

Last NPPES UpdateOctober 30, 2024

NPPES CertifiedOctober 30, 2024

✔ NPI 1932248101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Licenses✔ Licensed in OK · 4205✔ Licensed in GA · 101304

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

2624 DAWSON RD, Albany, GA 31707

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Secondary Practice Location 1

Location 1940 NE 13th St, 4G4250Oklahoma City, OK 73104-5008 · Phone (405) 271-5125 · Fax (405) 271-3462

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack Russelle Lake D.o. 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 ID648323840

PECOS Enrollment IDI20090805000816, I20260429002115

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 Reassignments

Medicare enrollment records show Jack Lake reassigns Medicare billing to 14 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Synergy Radiology, LLC

143 mi

Radiology

1501 MILSTEAD RD NE STE 140
Conyers, GA 30012

Reassigned Medicare billing, Georgia and Oklahoma enrollments
207 clinicians in this Medicare group

NPI 1558886341 (678) 374-7322

Pro Radiology, LLC

152 mi

Radiology

60 PEACHTREE PARK DR NE
Atlanta, GA 30309

Reassigned Medicare billing, Georgia and Oklahoma enrollments
Also billed through NPI 1942733308 (Oklahoma)
202 clinicians in this Medicare group

NPI 1164966461 (678) 278-8800

M & B Imaging, PC

187 mi

Radiology

1640 JESSE JEWELL PKWY SE STE 2
Gainesville, GA 30501

Reassigned Medicare billing, Georgia and Oklahoma enrollments
191 clinicians in this Medicare group

NPI 1932624723 (404) 296-5887

North Star Mri LP

735 mi

Radiology

997 RAINTREE CIRCLE, SUITE 110
Allen, TX 75013

Reassigned Medicare billing, Oklahoma enrollment
13 clinicians in this Medicare group

NPI 1033174701 (972) 954-8001

North Star Fp, LP

740 mi

Radiology

11970 N CENTRAL EXPY STE 100
Dallas, TX 75243

Reassigned Medicare billing, Oklahoma enrollment
12 clinicians in this Medicare group

NPI 1033630835 (972) 649-6460

North Star Diagnostic Imaging, LLC

740 mi

Radiology

3700 W 15TH ST, BUILDING D, SUITE 200
Plano, TX 75075

Reassigned Medicare billing, Oklahoma enrollment
12 clinicians in this Medicare group

NPI 1467787739 (972) 758-9000

North Star Mri Of Frisco LP

743 mi

Radiology

8501 WADE BLVD., SUITE 220
Frisco, TX 75034

Reassigned Medicare billing, Oklahoma enrollment
13 clinicians in this Medicare group

NPI 1649356759 (214) 618-3420

North Star Npt LP

744 mi

Radiology

6101 W PLANO PKWY STE 150
Plano, TX 75093

Reassigned Medicare billing, Oklahoma enrollment
13 clinicians in this Medicare group

NPI 1699387647 (972) 649-6460

North Star Cn, LP

747 mi

Radiology

4780 N JOSEY LN
Carrollton, TX 75010

Reassigned Medicare billing, Oklahoma enrollment
13 clinicians in this Medicare group

NPI 1013305945 (972) 492-1334

North Star Fm, LP

758 mi

Radiology

4951 LONG PRAIRIE ROAD, SUITE 105
Flower Mound, TX 75028

Reassigned Medicare billing, Oklahoma enrollment
13 clinicians in this Medicare group

NPI 1174812028 (972) 899-5901

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

Areas of Expertise CMS Part B claims 41

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

859 services556 patients

Ct scan head or brain without contrast 70450

A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.

238 services221 patients

Mri scan of brain without contrast 70551

An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.

116 services116 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

95 services94 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

76 services75 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

64 services50 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

63 services63 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

56 services55 patients

Ct scan of blood vessels of head with contrast 70496

A CT scan of the head's blood vessels with contrast is a diagnostic procedure. A special dye (contrast) is injected into your body to make the blood vessels visible on the scan. This helps identify issues like blockages or abnormalities in your head's blood vessels.

54 services53 patients

Mri scan of brain before and after contrast 70553

An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.

52 services50 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

51 services51 patients

Ct scan of blood vessels of neck with contrast 70498

A CT scan of the neck's blood vessels with contrast is a diagnostic procedure. It uses X-rays and a special dye to create detailed images of your neck's blood vessels. This helps doctors detect issues such as blockages or abnormalities.

46 services45 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

46 services46 patients

Imaging for evaluation of swallowing function 74230

This process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.

44 services44 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

40 services40 patients

Mri scan of upper spinal canal without contrast 72141

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

35 services35 patients

Nuclear medicine study, spect imaging, 1 area or single acquisition, single day imaging 78803

A nuclear medicine study with SPECT involves a safe, small amount of radioactive substance to help visualize body organs. SPECT, or Single Photon Emission Computed Tomography, creates detailed 3D images. This helps doctors diagnose and monitor conditions in a specific body area.

34 services34 patients

Ct scan of upper spine without contrast 72125

A CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.

33 services33 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

31 services31 patients

Mri scan of brain with contrast 70552

An MRI scan of the brain with contrast is a non-invasive imaging test. A dye is injected into a vein to enhance the images. The scan uses magnetic fields and radio waves to create detailed pictures of your brain, helping to identify abnormalities or diseases.

27 services27 patients

X-ray of hip, 1 view 73501

An X-ray of the hip, 1 view, is a quick, painless test where a small amount of radiation is used to produce images of the hip joint. This helps in diagnosing conditions like arthritis or fractures. You'll be positioned so that the X-ray machine can capture the best image of your hip.

26 services26 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

24 services19 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

24 services24 patients

Ct scan of lower spine without contrast 72131

A CT scan of the lower spine without contrast is a non-invasive imaging test. It uses X-rays to create detailed images of your lower back area, helping to detect conditions like fractures, infections, or tumors. It's painless and generally quick.

23 services23 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

23 services20 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

22 services21 patients

Low dose ct scan of chest for lung cancer screening 71271

A low-dose CT scan of the chest is a quick, painless procedure that uses a small amount of radiation to create detailed images of your lungs. It's a key tool for early detection of lung cancer, especially for those at high risk.

21 services21 patients

Ct scan of face without contrast 70486

A CT scan of the face without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your face, including bones, soft tissues, and blood vessels. It's often used to diagnose diseases, injuries, or abnormalities. No contrast dye is used in this procedure.

19 services19 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

19 services19 patients

Mri scan of lower spinal canal before and after contrast 72158

An MRI scan of the lower spinal canal with contrast is a non-invasive imaging procedure. It uses magnetic fields to generate detailed images of your lower spine. A contrast agent is injected to enhance these images, helping doctors see issues more clearly.

19 services19 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

18 services18 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

18 services18 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

16 services15 patients

Complete ultrasound scan of abdomen 76700

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

16 services16 patients

Mri scan of middle spinal canal without contrast 72146

An MRI scan of the middle spinal canal without contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed images of your spine. This helps doctors identify any abnormalities or issues in your spinal canal. No dye is used in this procedure.

14 services14 patients

Mri scan of upper spinal canal before and after contrast 72156

An MRI scan of the upper spinal canal before and after contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed images of your spine. Contrast dye is injected to enhance these images, providing clearer visuals for accurate diagnosis.

14 services13 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

14 services14 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

12 services12 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

12 services12 patients

3d radiographic procedure 76376

A 3D radiographic procedure is a non-invasive imaging test that helps doctors visualize the internal structures of your body in three dimensions. This advanced technology provides detailed images, aiding in accurate diagnosis and treatment planning. It involves exposure to minimal radiation.

12 services12 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31707 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

Most-billed visit code 99213

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Other Providers at the Same Location NPPES 10

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

MICHAEL WALTER RAMALIA JR. DO

Radiology (Diagnostic Radiology)