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NPI · 1124752233 · NPPES-sourced

Grace Lake

ActivePhysician Assistant
NPI Number
1124752233
Type 1 · Individual
Taxonomy Code
363A00000X
Contact
(541) 265-2244
License OR · PA221993
Last Updated
About 19 months ago (Nov 2024)
Enumerated 2022-07-13
Primary practice addressOR · 97365-4820
930 Sw Abbey StNewport, OR 97365-4820
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About this NPIWhat this record shows.

NPI 1124752233 is registered to Grace Lake, a Physician Assistant practising at 930 Sw Abbey St in Newport, Oregon. Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Grace Lake has been enumerated in the National Provider Identifier (NPI) registry since 2022.

Provider type
Individual (Type 1)
Status
Active
Enumerated
2022-07-13
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Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Grace Lake accepts. To confirm in-network status with your specific health plan, contact Grace Lake directly at (541) 265-2244.

Frequently asked

Yes. NPI 1124752233 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (541) 265-2244.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Grace Lake is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy363A00000X
Last updated2024-11
Enumerated2022-07-13
StatusActive
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6 records · same addressOther providers at this location.

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Same specialtyOther Physician Assistant providers in Oregon.

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Adjacent in the NPPES enumeration sequenceNPIs enumerated around this one.

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