Grace Lake
Physician Assistant β’ Newport, OR
930 Sw Abbey St
Newport, OR 973654820
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
930 Sw Abbey St
Newport, OR 973654820
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Physician Assistant: NPPES taxonomy is a reported classification, not proof of board certification.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2021β2025.
NPI first issued
2022
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, βDoes your provider accept Medicare as full payment?β
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Grace Lake has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Grace Lake as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Newport and Oregon
17 active clinicians are listed under Physician Assistant with a practice address in Newport, OR (2,095 in Oregon).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Newport
5.9% of these 17 clinicians have the CMS telehealth indicator.
58.8% of these 17 clinicians are listed by CMS as accepting Medicare assignment.
Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2024-11-08NUCC Taxonomy Code: 363A00000X
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - PHYSICIAN ASSISTANT
I20240827001231
OR
0840739595
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Physician Assistant
Physician Assistant (Certified)
Emergency Medicine
Doctor of Medicine (M.D.)
Physician Assistant
Physician Assistant (Certified)
Nurse Anesthetist, Certified Registered
Certified Registered Nurse Anesthetist
Physical Therapist
Physical Therapist
Emergency Medicine
Doctor of Osteopathic Medicine (D.O.)
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Physician Assistant (license number reported to NPPES: OR PA221993)
Registered at 930 SW ABBEY ST, NEWPORT, OR 973654820 (Tel: 5412652244)
Registered at 930 SW ABBEY ST, NEWPORT, OR 973654820
Physician Assistant
Registered at 1100 NORTH AVE, GRAND JUNCTION, CO 815013122 (Tel: 9702481635)
NPI status registered as active in NPPES database
Registered at 11241 W UTAH PL, LAKEWOOD, CO 802326153 (Tel: 7202025209)
Registered at 11241 W UTAH PL, LAKEWOOD, CO 802326153
Recorded as GRACE LAKE
Student in an Organized Health Care Education/Training Program
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Physician Assistants in Newport
- Robert Barkus, PA-C
- Jason Rutter, PA-C
- Kathryn Williams, PA
- Christopher Hart, PA-C
- Michael Cruise, PA-C
- Jason Brown, PA-C
Mailing Address
930 Sw Abbey St
Newport, OR 973654820