Kevin Lack, P.A.-C
NPI 1417924028 · Surgical Physician Assistant · Augusta, GA
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kevin Lack, P.A.-C is a Surgical Physician Assistant provider in Augusta, GA (NPI 1417924028).
Provider details
- NPI number
- 1417924028
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- P.A.-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA-1765 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
20 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
439 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. 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.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Preparation of Skin Graft Site of Trunk, Arms, Or Legs, Each Additional 100.0 Sq Cm Or 1% Body Area for Infants and Children, Or Less15003 | 337 | $6 |
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 35 Minutes99232 | 45 | $63 |
| Preparation of Skin Graft Site of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body Area for Infants and Children, Or Less15002 | 36 | $30 |
| Preparation of Skin Graft Site of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around Eyes, Genitals, Hands, Feet, Fingers, Or Toes, 100.0 Sq Cm Or 1% Body Area for Infants and Children, Or Less15004 | 21 | $34 |
Typical Medicare-allowed amounts for these services range $6–$63 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Additional practice locations (1)
- 3651 Wheeler RdAugusta, GA 30909-6521Phone: (706) 863-9595
Registry dates
- Enumerated
- 2006-03-02
- Last updated
- 2025-03-10
- Certified
- 2025-03-10
Frequently asked questions
- What is Kevin Lack's NPI number?
- Kevin Lack's National Provider Identifier (NPI) is 1417924028, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kevin Lack's specialty?
- Kevin Lack is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kevin Lack located?
- Kevin Lack's practice location on file with NPPES is 3675 J Dewey Gray Circle, Augusta, GA 30909-1868.
- What is Kevin Lack's phone number?
- The practice phone number listed in the NPPES registry for Kevin Lack is (706) 863-9595.
- Does Kevin Lack accept Medicare?
- Kevin Lack is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kevin Lack's NPI active?
- Yes — Kevin Lack's NPI (1417924028) is active in the NPPES registry as of the last update on 2025-03-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.