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DR. CHARLES J. LIGHTDALE M.D.
NPI 1063586014
Internal Medicine - Gastroenterology in New York, NY

Active since November 20, 2006PECOS Enrolled
161 FORT WASHINGTON AVE, NEW YORK, NY 10032(212) 305-4382 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Charles J. Lightdale M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHARLES J. LIGHTDALE M.D. (NPI 1063586014) is an individual gastroenterology provider in New York, New York, licensed in New York (108616) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063586014
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. CHARLES J. LIGHTDALECredential: M.D.
Location Address161 FORT WASHINGTON AVENew York, NY 10032-3729
Mailing Address630 W 168th St # 4, Vc 12th Floor, Suite 208New York, NY 10032-3725
Phone(212) 305-4382
Sole ProprietorYes
Enumeration DateNovember 20, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1063586014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in NY · 108616
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
161 FORT WASHINGTON AVE, New York, NY 10032
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Other Identifiers 3

Medicaid01579244NY
Medicare UPINB16827NY
Medicare ID-Type Unspecified578291NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Charles J. Lightdale M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10032 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAUREEN LICURSI CPNP
Nurse Practitioner (Pediatrics)
161 FORT WASHINGTON AVE, 7TH FLOOR
NEW YORK, NY 10032
New York County (212) 305-2466
BARBARA THERESE ROBBINS APRN-BC
Nurse Practitioner (Family)
161 FORT WASHINGTON AVE, ROOM 661
NEW YORK, NY 10032
New York County (212) 342-0886
VARSHA JOHN
Student in an Organized Health Care Education/Training Program
161 FORT WASHINGTON AVE
NEW YORK, NY 10032
New York County (212) 305-5221
MICHELLE BENGAL PA
Physician Assistant
161 FORT WASHINGTON AVE
NEW YORK, NY 10032
New York County (818) 614-2424
DR. NICOLA CORVAJA M.D.
Internal Medicine (Interventional Cardiology)
161 FORT WASHINGTON AVE
NEW YORK, NY 10032
New York County (212) 342-3616
RACHEL CONYBEARE N.P.
Nurse Practitioner (Adult Health)
161 FORT WASHINGTON AVE, HERBERT IRVING PAVILION ROOM # 903
NEW YORK, NY 10032
New York County (212) 305-5275
DR. SUNEETA KRISHNAREDDY MD
Internal Medicine (Gastroenterology)
161 FORT WASHINGTON AVE
NEW YORK, NY 10032
New York County (212) 305-2323
DAVID M WEINER MD
Urology
161 FORT WASHINGTON AVE, 11TH FLOOR
NEW YORK, NY 10032
New York County (212) 305-0114

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Lightdale's NPI number?

The NPI number for Charles Lightdale is 1063586014. It was assigned to this individual provider in the NPPES registry on November 20, 2006.

Where is Charles Lightdale located?

Charles Lightdale practices at 161 Fort Washington Ave, New York, NY 10032. The listed phone number is (212) 305-4382.

What is Charles Lightdale's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Charles Lightdale enrolled in Medicare?

Yes. Charles Lightdale is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Charles Lightdale was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.