Kenneth B Lake, CRNA in Fontana, CA - Medicare Certified Registered Nurse Anesthetist (crna)

Kenneth B Lake, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Fontana, California. He graduated from nursing school in 2005 and has 19 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Northstar Anesthesia Of Montana, Delta County Memorial Hospital and his current practice location is 9961 Sierra Ave, Fontana, California. You can reach out to his office (for appointments etc.) via phone at (909) 427-3910.

Kenneth B Lake is licensed to practice in California (license number NA3286) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1003964024.

Contact Information

	Kenneth B Lake, CRNA
	9961 Sierra Ave, Fontana, CA 92335-6720
	(909) 427-3910
	Not Available

Map and Direction

Provider's Profile

Full Name	Kenneth B Lake
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	19 Years
Location	9961 Sierra Ave, Fontana, California
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kenneth B Lake graduated from nursing school in 2005

NPI Data:

NPI Number: 1003964024
Provider Enumeration Date: 01/08/2007
Last Update Date: 09/15/2008

Medicare PECOS Information:

PECOS PAC ID: 6608936752
Enrollment ID: I20200915002450

Medical Identifiers

Medical identifiers for Kenneth B Lake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003964024	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	NA3286 (California)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Delta County Memorial Hospital	Delta, CO	Hospital
Great Falls Clinic Hospital	Great falls, MT	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Northstar Anesthesia Of Montana	5395151294	11
Delta County Memorial Hospital	1850200601	59

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenneth B Lake allows following entities to bill medicare on his behalf.

Entity Name	Cmsc Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1639109978 PECOS PAC ID: 5890602494 Enrollment ID: O20130502000527

Entity Name	Northstar Anesthesia Of Montana
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265059869 PECOS PAC ID: 5395151294 Enrollment ID: O20210301001196

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth B Lake is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kenneth B Lake, CRNA 9961 Sierra Ave, Fontana, CA 92335-6720 Ph: (909) 427-3910	Kenneth B Lake, CRNA 9961 Sierra Ave, Fontana, CA 92335-6720 Ph: (909) 427-3910

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Fontana, CA

Kadette Kelly, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910
Ronald D Stephens, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910
Alyssa Wilson, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 000-000-0000
Hisham Maassarani, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-302-4886
Edith M Marca-solomon, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910
Heather J Maddox, RN, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-5000

Kenneth B Lake, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Fontana, CA