Jon M Lake, MD - Medicare Family Medicine in Jackson, MI

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Jon M Lake, MD is a medicare enrolled "Family Medicine" physician in Jackson, Michigan. His current practice location is 400 Hinckley Blvd, Suite 100, Jackson, Michigan. You can reach out to his office (for appointments etc.) via phone at (517) 784-0588.

Jon M Lake is licensed to practice in Michigan (license number 4301068180) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1376561696.

Contact Information

Jon M Lake, MD
400 Hinckley Blvd, Suite 100,
Jackson, MI 49203-6125
(517) 784-0588
(517) 784-3866

Map and Direction




Physician's Profile

Full NameJon M Lake
GenderMale
SpecialityFamily Medicine
Location400 Hinckley Blvd, Jackson, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1376561696
  • Provider Enumeration Date: 07/17/2006
  • Last Update Date: 02/17/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 1254242217
  • Enrollment ID: I20061130000131

Medical Identifiers

Medical identifiers for Jon M Lake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376561696NPI-NPPES
P00420975OtherMIRR MEDICARE
80169124OtherMIRR MEDICARE
5187092-10MedicaidMI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 4301068180 (Michigan)Primary

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. Jon M Lake allows following entities to bill medicare on his behalf.
Entity NameIndependent Emergency Physicians, P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780791343
PECOS PAC ID: 6709798325
Enrollment ID: O20031103000407
Entity NameW.a. Foote Memorial Hospital, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760437826
PECOS PAC ID: 0244136067
Enrollment ID: O20031212000691
Entity NameCenter For Family Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780784439
PECOS PAC ID: 4587574421
Enrollment ID: O20040219000916
Entity NameIndependent Observation Physicians Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700119500
PECOS PAC ID: 3577603604
Enrollment ID: O20091221000327
Entity NameIndependent Hospitalist Physicians Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851820641
PECOS PAC ID: 3971874090
Enrollment ID: O20170808003906
Entity NameIep - Post Acute Care Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760166821
PECOS PAC ID: 0648631812
Enrollment ID: O20230803003290

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. Jon M 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 AddressPractice Location Address
Jon M Lake, MD
Po Box 67000, Department 272801,
Detroit, MI 48267-0002

Ph: (517) 784-0588		Jon M Lake, MD
400 Hinckley Blvd, Suite 100,
Jackson, MI 49203-6125

Ph: (517) 784-0588

Reviews and Comments


Family Medicine Doctors in Jackson, MI

Rubana Khan, DO
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Practice Location: 205 N East Ave, Jackson, MI 49201
Phone: 810-931-5407    
Erin Nicole Murfey, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 400 Hinckley Blvd, Ste 100, Jackson, MI 49203
Phone: 517-784-0141    Fax: 517-787-3462
Maria Soto, DO
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Practice Location: 1401 W North St, Jackson, MI 49202
Phone: 517-782-2555    Fax: 517-782-3399
Mohamed El Fakiy, MD
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Medicare: Medicare Enrolled
Practice Location: 205 N East Ave, Jackson, MI 49201
Phone: 816-394-6643    
Dr. Robert N Israel, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 124 Seymour Ave, Jackson, MI 49202
Phone: 517-782-5700    Fax: 517-782-3141
Ray H King, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 400 Hinckley Blvd, Suite 100, Jackson, MI 49203
Phone: 517-784-0588    Fax: 517-784-3866
William Bradley Bivens, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2585 Spring Arbor Rd, Jackson, MI 49203
Phone: 517-784-0032    Fax: 517-784-8959

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.