Dr Clifton Rudolph Lake, MD is a medicare enrolled "Psychiatric Hospital" physician in Valley Stream, New York. He graduated from medical school in 1987 and has 37 years of diverse experience with area of expertise as Psychiatry. He is a member of the group practice Apalachee Center Inc and his current practice location is
46 Brook Rd, Valley Stream, New York. You can reach out to his office (for appointments etc.) via phone at
(516) 508-0128.
Dr Clifton Rudolph Lake is licensed to practice in New York (license number P60621) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063698330.
Physician's Profile
| Full Name | Dr Clifton Rudolph Lake |
|---|
| Gender | Male |
|---|
| Speciality | Psychiatry |
|---|
| Experience | 37 Years |
|---|
| Location | 46 Brook Rd, Valley Stream, New York |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Dr Clifton Rudolph Lake graduated from medical school in 1987
NPI Data:
- NPI Number: 1063698330
- Provider Enumeration Date: 01/16/2008
- Last Update Date: 05/20/2020
Medicare PECOS Information:
- PECOS PAC ID: 1759534472
- Enrollment ID: I20200207001491
Medical Identifiers
Medical identifiers for Dr Clifton Rudolph Lake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063698330 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ACN1119 (Florida) | Secondary |
| 283Q00000X | Psychiatric Hospital | P60621 (New York) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Apalachee Center Inc | 3577556604 | 28 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Clifton Rudolph Lake allows following entities to bill medicare on his behalf.
| Entity Name | Apalachee Center Inc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1548360993
PECOS PAC ID: 3577556604
Enrollment ID: O20040405001882 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Clifton Rudolph Lake is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Clifton Rudolph Lake, MD
46 Brook Rd,
Valley Stream, NY 11581-2416
Ph: (516) 508-0128 | Dr Clifton Rudolph Lake, MD
46 Brook Rd,
Valley Stream, NY 11581-2416
Ph: (516) 508-0128 |
Reviews and Comments