SPENCER LEE LAKE
NPI 1932869377
Nurse Practitioner - Family in Bountiful, UT

Q: What is Spencer Lake's NPI number?

The NPI number for Spencer Lake is 1932869377. It was assigned to this individual provider in the NPPES registry on December 27, 2021.

Q: What is Spencer Lake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Spencer Lake was last updated on December 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since December 27, 2021PECOS EnrolledAccepts Medicare Assignment

557 W 2600 S, BOUNTIFUL, UT 84010(801) 298-9155(801) 298-9156 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Spencer Lee Lake NPPES

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

SPENCER LEE LAKE (NPI 1932869377) is an individual family provider in Bountiful, Utah, licensed in Utah (6342236-4405) and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS, is affiliated with Lakeview Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1932869377

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameSPENCER LEE LAKE

Location Address557 W 2600 SBountiful, UT 84010-7717

Mailing Address557 W 2600 SBountiful, UT 84010-7717 · (801) 298-9155 · Fax (801) 298-9156

Phone(801) 298-9155

Fax(801) 298-9156

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateDecember 27, 2021

NPPES CertifiedDecember 27, 2021

✔ NPI 1932869377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in UT · 6342236-4405

557 W 2600 S, Bountiful, UT 84010

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, Select Health and more.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

Spencer Lee Lake 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 ID446642763

PECOS Enrollment IDI20220119001144

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.

Areas of Expertise CMS Part B claims 6

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

118 services62 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

36 services36 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

36 services36 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

25 services23 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

18 services18 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

17 services17 patients

Hospital Affiliations CMS Care Compare

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

Lakeview Hospital

Acute Care Hospitals · Bountiful, UT

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number460042

Location630 East Medical DriveBountiful, UT 84010 · Davis County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84010 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

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

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.

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Other Providers at the Same Location NPPES 15

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

ALLISON HANNA D.O.

Family Medicine