DR. DAVID LAKE GORMSEN D.O.
NPI 1619014602
Emergency Medicine - Pediatric Emergency Medicine in Canton, OH
NPI Status: Active since January 31, 2007
Contact Information
1320 MERCY DR NW
CANTON, OH
ZIP 44708
Phone: (330) 489-1074
Fax: (330) 489-1487
- Individual
- Male
- Emergency Medicine
- Pediatric Emergency Medicine
- PECOS Enrolled
About DAVID GORMSEN
This page provides the complete NPI Profile along with additional information for David Gormsen, a provider established in Canton, Ohio with a medical specialization in Emergency Medicine, focusing in pediatric emergency medicine . The healthcare provider is registered in the NPI registry with number 1619014602 assigned on January 2007. The practitioner's primary taxonomy code is 207PP0204X with license number 34002838 (OH). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1619014602
- Provider Name
- DR. DAVID LAKE GORMSEN D.O.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1320 MERCY DR NW CANTON, OH 44708
- Location Phone
- (330) 489-1074
- Location Fax
- (330) 489-1487
- Mailing Address
- 4189 SONGBIRD TRL STOW, OH 44224
- Mailing Phone
- (330) 688-4160
- Mailing Fax
- (330) 489-1487
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 01-31-2007
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine Pediatric Emergency Medicine
- Taxonomy Code
- 207PP0204X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 34002838
- License State
- OH
- Taxonomy Description
- Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 34002838 | OTHER (01) | OH | MEDICAL LICENSE NUMBER |
Medicare Participation & PECOS Enrollment Status
David Gormsen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 44708 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.72
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.65
- Average New Patient Copayment $21.18
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.66
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.44
- Minimum Established Patient Price $17.1
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $24.11
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 1 | 9 | 0 | 1 | 4 | 6 | 0 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 2 | 9 | 0 | 1 | 8 | 6 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 2 + 9 + 0 + 1 + 8 + 6 + 0 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1619014602 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1851390116 | JOSEPH A MENDIOLA MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1326048158 | THOMAS J BARBUSH MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1073513859 | ROBERT E REAVEN MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1902806748 | DAVID BRINE MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1588664361 | DAVID W SPRIGGS MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1942200761 | RADIOLOGY SERVICES OF CANTON, INC. Organization | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1295735025 | DAE H BANG MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1326048166 | MARK R DEGALAN MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1912907767 | BARRY C MCNULTY MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1801896659 | JOHN N RAUCHENSTEIN MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1811997679 | WILLIAM D MURPHY MD Individual | Radiology (Diagnostic Radiology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1070 |
| 1174523666 | SELECT SPECIALTY HOSPITAL - NORTHEAST OHIO INC Organization | Long Term Care Hospital | 1320 MERCY DR NW 6TH FLOOR CANTON, OH 44708 (330) 344-1030 |
| 1245211564 | ELIZABETH BAUM MD Individual | Internal Medicine | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1066 |
| 1457333783 | ANJU G MADER MD Individual | Pediatrics | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1044 |
| 1174505408 | MARK N BLASER DO Individual | Pediatrics | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1044 |
| 1730161852 | J RICHARD ZIEGLER MD Individual | Internal Medicine | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1066 |
| 1467434696 | MANGALA V BETKERUR MD Individual | Pediatrics (Neonatal-Perinatal Medicine) | 1320 MERCY DR NW CANTON, OH 44708 (330) 580-4771 |
| 1396727525 | IRWIN J WEINFELD MD Individual | Pediatrics (Neonatal-Perinatal Medicine) | 1320 MERCY DR NW CANTON, OH 44708 (330) 580-4771 |
| 1841272705 | MODERNPATH INC Organization | Pathology (Anatomic Pathology & Clinical Pathology) | 1320 MERCY DR NW CANTON, OH 44708 (330) 489-1000 |
| 1518949304 | RAJESH K MALIK MD Individual | Pediatrics (Neonatal-Perinatal Medicine) | 1320 MERCY DR NW CANTON, OH 44708 (330) 580-4771 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619014602, enumerated in the NPI registry as an "individual" on January 31, 2007
The provider is located at 1320 Mercy Dr Nw Canton, Oh 44708 and the phone number is (330) 489-1074
The provider's speciality is Emergency Medicine with taxonomy code 207PP0204X with a focus in Pediatric Emergency Medicine
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $84.72 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on January 31, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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