Lake Obstetrics and Gynecology, Inc
NPI 1811950447 · Obstetrics & Gynecology Physician · Mentor, OH
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1811950447
- Entity type
- Organization
- Primary specialty
- Obstetrics & Gynecology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Susanna Bowman, Office Manager(440) 357-7100
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
4 documented practice locations
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
Additional practice locations (3)
- 7580 Auburn Rd Ste 313Concord Twp, OH 44077-9618Phone: (440) 352-0688Fax: (440) 352-3724
- 6270 N Ridge RdMadison, OH 44057-2567Phone: (440) 357-7100Fax: (440) 357-8132
- 9500 Mentor AveMentor, OH 44060-8713Phone: (440) 357-7100Fax: (440) 357-8132
Registry dates
- Enumerated
- 2006-04-06
- Last updated
- 2025-08-07
- Certified
- 2025-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.