Dr Katelyn Marie Lake, CRNA in South Bend, IN - Medicare Certified Registered Nurse Anesthetist (crna)

Dr Katelyn Marie Lake, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in South Bend, Indiana. She graduated from nursing school in 2022 and has 2 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Southeast Anesthesiologists, Inc. and her current practice location is 615 N Michigan St, South Bend, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 647-1000.

Dr Katelyn Marie Lake is licensed to practice in Indiana (license number 138174) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1811631898.

Contact Information

	Dr Katelyn Marie Lake, CRNA
	615 N Michigan St, South Bend, IN 46601-1087
	(574) 647-1000
	Not Available

Map and Direction

Provider's Profile

Full Name	Dr Katelyn Marie Lake
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	2 Years
Location	615 N Michigan St, South Bend, Indiana
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Katelyn Marie Lake graduated from nursing school in 2022

NPI Data:

NPI Number: 1811631898
Provider Enumeration Date: 04/25/2022
Last Update Date: 05/08/2023

Medicare PECOS Information:

PECOS PAC ID: 9335526391
Enrollment ID: I20220512000287

Medical Identifiers

Medical identifiers for Dr Katelyn Marie Lake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811631898	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	28229724A (Indiana)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	138174 (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Memorial Hospital Of South Bend	South bend, IN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Southeast Anesthesiologists, Inc.	6800837980	91

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. Dr Katelyn Marie Lake allows following entities to bill medicare on her behalf.

Entity Name	Southeast Anesthesiologists, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548210685 PECOS PAC ID: 6800837980 Enrollment ID: O20050518001265

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. Dr Katelyn Marie 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
Dr Katelyn Marie Lake, CRNA 50778 Sturdy Oak Ct, Granger, IN 46530-6727 Ph: (219) 405-7898	Dr Katelyn Marie Lake, CRNA 615 N Michigan St, South Bend, IN 46601-1087 Ph: (574) 647-1000

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in South Bend, IN

Ms. Jamie Ann Davidson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1536 Crestwood Blvd, South Bend, IN 46635 Phone: 574-360-2619
Alvaro Andres Osorio, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-1000
Hilda Bartel, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-1000
Mrs. Julie Anne Addis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 53830 Generations Dr, South Bend, IN 46635 Phone: 574-271-0893
Tyler Allen Rex, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 754-647-1000
Janet Vardaman, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 17501 Generations Dr, South Bend, IN 46635 Phone: 574-234-0049

Dr Katelyn Marie Lake, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in South Bend, IN