CARISSA M LACKEY MD, MPH
NPI 1629642624
Family Medicine in Cambridge, NY
NPI Status: Active since May 14, 2021
Contact Information
35 GILBERT STREET
CAMBRIDGE MEDICAL CENTER
CAMBRIDGE, NY
ZIP 12816
Phone: (518) 677-3961
Fax: (518) 677-3180
- Individual
- Female
- Family Medicine
- PECOS Enrolled
About CARISSA LACKEY
This page provides the complete NPI Profile along with additional information for Carissa Lackey, a primary care provider established in Cambridge, New York with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1629642624 assigned on May 2021. The practitioner's primary taxonomy code is 207Q00000X with license number 332725 (NY). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1629642624
- Provider Name
- CARISSA M LACKEY MD, MPH
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816
- Location Phone
- (518) 677-3961
- Location Fax
- (518) 677-3180
- Mailing Address
- 100 PARK STREET GLENS FALLS HOSPITAL - CREDENTIALING GLENS FALLS, NY 12801
- Mailing Phone
- (518) 926-5924
- Mailing Fax
- (518) 677-3180
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-14-2021
- Last Update Date
- 09-24-2024
- Code Navigator
A primary care provider (PCP) like Carissa Lackey sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 332725
- License State
- NY
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Medicare Participation & PECOS Enrollment Status
Carissa Lackey 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 12816 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.93
- Minimum New Patient Price $54.87
- Maximum New Patient Price $166.88
- Average New Patient Copayment $21.23
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.08
- Minimum Established Patient Price $17.54
- Maximum Established Patient Price $136.14
- Average Established Patient Copayment $24.27
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.03
* 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 | 2 | 9 | 6 | 4 | 2 | 6 | 2 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 12 | 4 | 4 | 6 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 1 + 2 + 4 + 4 + 6 + 4 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1629642624 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 9 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1912239468 | JEFFREY ERIC STARK RPA-C Individual | Physician Assistant | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3961 |
| 1003551128 | ABIGAIL GRAVES Individual | Nurse Practitioner (Family) | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3961 |
| 1912640376 | KEANA NICOLE ALBERT PA Individual | Physician Assistant | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3961 |
| 1316602402 | AZIA JODECI SAYERS FNP Individual | Nurse Practitioner (Family) | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3163 |
| 1386261865 | DR. KATY UNDERWOOD MD Individual | Family Medicine | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3961 |
| 1538107388 | MISS JESSICA BLYTHE CRANE PA Individual | Physician Assistant | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3163 |
| 1235998543 | MORGAN PATRICIA WASICZKO FNP Individual | Nurse Practitioner (Family) | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3961 |
| 1174107080 | BRANDON TOWEY MD Individual | Family Medicine | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3961 |
| 1295347466 | KATELYNN HATALSKY MS, PA-C Individual | Physician Assistant | 35 GILBERT STREET CAMBRIDGE MEDICAL CENTER CAMBRIDGE, NY 12816 (518) 677-3163 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629642624, enumerated in the NPI registry as an "individual" on May 14, 2021
The provider is located at 35 Gilbert Street Cambridge Medical Center Cambridge, Ny 12816 and the phone number is (518) 677-3961
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
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 $84.93 with an average copayment of $21.23 for new patient appointments. Established patients should expect a typical charge of $97.08 and an average copayment of 24.27. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on May 14, 2021. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.