Jack Russelle Lake, DO in Albany, GA - Medicare Diagnostic Radiology

Jack Russelle Lake, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Albany, Georgia. He graduated from medical school in 2003 and has 21 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Norman Radiology Services, Inc and his current practice location is 2624 Dawson Rd, Albany, Georgia. You can reach out to his office (for appointments etc.) via phone at (229) 888-1624.

Jack Russelle Lake is licensed to practice in Oklahoma (license number 4205) 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 1932248101.

Contact Information

	Jack Russelle Lake, DO
	2624 Dawson Rd, Albany, GA 31707-1609
	(229) 888-1624
	Not Available

Map and Direction

Physician's Profile

Full Name	Jack Russelle Lake
Gender	Male
Speciality	Diagnostic Radiology
Experience	21 Years
Location	2624 Dawson Rd, Albany, Georgia
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:

Jack Russelle Lake graduated from medical school in 2003

NPI Data:

NPI Number: 1932248101
Provider Enumeration Date: 02/05/2007
Last Update Date: 10/30/2024

Medicare PECOS Information:

PECOS PAC ID: 0648323840
Enrollment ID: I20090805000816

Medical Identifiers

Medical identifiers for Jack Russelle Lake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932248101	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	101304 (Georgia)	Secondary
2085R0202X	Radiology - Diagnostic Radiology	4205 (Oklahoma)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Integris Southwest Medical Center	Oklahoma city, OK	Hospital
Integris Baptist Medical Center, Inc	Oklahoma city, OK	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Norman Radiology Services, Inc	2466496641	7

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. Jack Russelle Lake allows following entities to bill medicare on his behalf.

Entity Name	Norman Radiology Services, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326039645 PECOS PAC ID: 2466496641 Enrollment ID: O20050617000884

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. Jack Russelle 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
Jack Russelle Lake, DO 700 E Morehead St Ste 300, Charlotte, NC 28202-2742 Ph: () -	Jack Russelle Lake, DO 2624 Dawson Rd, Albany, GA 31707-1609 Ph: (229) 888-1624

Reviews and Comments

Radiology Doctors in Albany, GA

Dr. Allison Lea Hays, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 417 W 3rd Ave, Albany, GA 31701 Phone: 706-653-1088 Fax: 706-653-1162
Suresh K Lakhanpal, MD Radiology Medicare: Medicare Enrolled Practice Location: 417 W 3rd Ave, Albany, GA 31701 Phone: 706-653-1088 Fax: 706-653-1162
Edwin J Fortenbery, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 417 W 3rd Ave, Albany, GA 31701 Phone: 706-653-1088 Fax: 706-653-1162
Frank Maynard Thames Jr., M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 2219 Golf Course Dr, Albany, GA 31721 Phone: 229-435-2964
William Joel Mcafee, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 425 W 3rd Ave Ste 50, Albany, GA 31701 Phone: 229-883-0717
Karen E Lovett, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 417 W 3rd Ave, Albany, GA 31701 Phone: 706-653-1088 Fax: 706-653-1162
Michael A Aquadro, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2000 Palmyra Rd, Palmyra Medical Center, Albany, GA 31701 Phone: 229-434-2000

Jack Russelle Lake, DO - Medicare Diagnostic Radiology in Albany, GA