Grace Lake
NPI 1124752233 · Physician Assistant · Newport, OR
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Grace Lake is a Physician Assistant provider in Newport, OR (NPI 1124752233).
Provider details
- NPI number
- 1124752233
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- PA221993 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-07-13
- Last updated
- 2024-11-08
- Certified
- 2024-11-08
Frequently asked questions
- What is Grace Lake's NPI number?
- Grace Lake's National Provider Identifier (NPI) is 1124752233, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Grace Lake's specialty?
- Grace Lake is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Grace Lake located?
- Grace Lake's practice location on file with NPPES is 930 Sw Abbey St, Newport, OR 97365-4820.
- What is Grace Lake's phone number?
- The practice phone number listed in the NPPES registry for Grace Lake is (541) 265-2244.
- Does Grace Lake accept Medicare?
- Grace Lake is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Grace Lake's NPI active?
- Yes — Grace Lake's NPI (1124752233) is active in the NPPES registry as of the last update on 2024-11-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.