Lake Champlain Physician Services - Medicare Primary Care in Plattsburgh, NY

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Lake Champlain Physician Services is a medicare enrolled primary clinic (Internal Medicine) in Plattsburgh, New York. The current practice location for Lake Champlain Physician Services is 210 Cornelia St, Suite 303, Plattsburgh, New York. For appointments, you can reach them via phone at (518) 562-7541. The mailing address for Lake Champlain Physician Services is Po Box 2868, Plattsburgh, New York and phone number is (518) 562-7541.

Lake Champlain Physician Services is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1083915268. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (518) 562-7541.

Contact Information

Lake Champlain Physician Services
210 Cornelia St
Suite 303
Plattsburgh
NY 12901-2318
(518) 562-7541
(518) 562-7542

Map and Direction


Primary Care Clinic Profile

Full NameLake Champlain Physician Services
SpecialityInternal Medicine
Location210 Cornelia St, Plattsburgh, New York
Authorized Official Name and PositionWouter Rietsema (PRESIDENT)
Authorized Official Contact5185627330
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lake Champlain Physician Services
Po Box 2868
Plattsburgh
NY 12901-0259

Ph: (518) 562-7541		Lake Champlain Physician Services
210 Cornelia St
Suite 303
Plattsburgh
NY 12901-2318

Ph: (518) 562-7541

NPI Details:

NPI Number1083915268
Provider Enumeration Date11/04/2010
Last Update Date11/04/2010

Medicare PECOS Information:

Medicare PECOS PAC ID1355528738
Medicare Enrollment IDO20110613000313

Medical Identifiers

Medical identifiers for Lake Champlain Physician Services such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083915268NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Primary
207RC0000XInternal Medicine - Cardiovascular Disease (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Lake Champlain Physician Services acts as a billing entity for following providers:
Provider NameMyrna A Sanchez-latreille
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1134107600
PECOS PAC ID: 1850295841
Enrollment ID: I20040511001651
Provider NameJan E Duus
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1114098589
PECOS PAC ID: 4284607797
Enrollment ID: I20040813000518
Provider NameChristopher S Palma
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1184637233
PECOS PAC ID: 3173599834
Enrollment ID: I20040903000941
Provider NameAnjni G Bhagat
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1013019454
PECOS PAC ID: 5395731087
Enrollment ID: I20050504000062
Provider NameNidal Makhoul
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1063409282
PECOS PAC ID: 4284548819
Enrollment ID: I20070129000214
Provider NameRobert Michael Lobel
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1154379063
PECOS PAC ID: 1759394851
Enrollment ID: I20070716000033
Provider NameTodd J Whitman
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1073585055
PECOS PAC ID: 0749217313
Enrollment ID: I20080618000394
Provider NameSeema A Lodha
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1497945596
PECOS PAC ID: 4789760976
Enrollment ID: I20081028000340
Provider NameWilliam B Bunn
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1285626986
PECOS PAC ID: 2567524598
Enrollment ID: I20081229000285
Provider NameAnna M Youngblood
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1730163619
PECOS PAC ID: 2668511080
Enrollment ID: I20091124000644
Provider NameWendy A Gilchrist
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1790872125
PECOS PAC ID: 9133243587
Enrollment ID: I20100908000136
Provider NameTeimuraz Apridonidze
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1801064019
PECOS PAC ID: 5294850178
Enrollment ID: I20100915000835
Provider NameJoel M Wolkowicz
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1720091861
PECOS PAC ID: 6002882768
Enrollment ID: I20100920000303
Provider NameBrent W Hastings
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1902819030
PECOS PAC ID: 4183651482
Enrollment ID: I20100920000318
Provider NameAlbert M Imobersteg
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1518161496
PECOS PAC ID: 1759477144
Enrollment ID: I20110405000268
Provider NameAnn J Heywood
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548540198
PECOS PAC ID: 9830356161
Enrollment ID: I20120130000053
Provider NameAlfred M Loka
Provider TypePractitioner - Cardiac Electrophysiology
Provider IdentifiersNPI Number: 1427257500
PECOS PAC ID: 9335327683
Enrollment ID: I20120705000398
Provider NameMarianna Worczak
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1609190560
PECOS PAC ID: 2466695069
Enrollment ID: I20130829000713
Provider NameWajih Aksamawati Dit Arja
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1962718551
PECOS PAC ID: 6507083185
Enrollment ID: I20140805001059
Provider NamePierre Znojkiewicz
Provider TypePractitioner - Cardiac Electrophysiology
Provider IdentifiersNPI Number: 1851435275
PECOS PAC ID: 9234355074
Enrollment ID: I20140814000237
Provider NameHanna B Slim
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1417130410
PECOS PAC ID: 0749332229
Enrollment ID: I20150914001040
Provider NameBrian D Henry
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1245492842
PECOS PAC ID: 0042451403
Enrollment ID: I20151222000097
Provider NameAderonke O Adeniyi
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1407090095
PECOS PAC ID: 8820376502
Enrollment ID: I20161101000155
Provider NameJoseph F Winget
Provider TypePractitioner - Cardiac Electrophysiology
Provider IdentifiersNPI Number: 1275632267
PECOS PAC ID: 5799880498
Enrollment ID: I20180424001357
Provider NameDonielle F Sliwa
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1376809277
PECOS PAC ID: 9032343140
Enrollment ID: I20180904000834

Reviews and Comments


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Phone: 518-565-4840    Fax: 518-565-4717
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.