Grace Lake
NPI 1124752233ActiveIndividual· Physician Assistant· Newport, OR
Physician Assistant in Newport, Oregon, licensed in OR, with an NPI issued in July 2022. Part D covered 44 prescriptions written in 2024, 86% of them generic.
Overview
| NPI | 1124752233 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jul 13, 2022 |
| Last updated in NPPES | Nov 8, 2024 |
| Certified by provider | Nov 8, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA221993 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OR) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 44 · 44 30-day fills |
|---|---|
| Patients | 32 |
| Total drug cost | $2,133 |
| Generic share | 86% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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