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DR. CLIFTON RUDOLPH LAKE MD
NPI 1063698330
Psychiatric Hospital in Valley Stream, NY

Active since January 16, 2008PECOS EnrolledAccepts Medicare Assignment
46 BROOK RD, VALLEY STREAM, NY 11581(516) 508-0128 Get Directions Write a Review

NPPES record last updated: May 20, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Clifton Rudolph Lake Md NPPES

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

DR. CLIFTON RUDOLPH LAKE MD (NPI 1063698330) is an individual psychiatric hospital provider in Valley Stream, New York, licensed in New York (P60621) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS and is a graduate of Other (1987).

NPPES Registry Identity

NPI1063698330
Entity TypeIndividualMale
Primary Taxonomy283Q00000X
Provider Legal NameDR. CLIFTON RUDOLPH LAKECredential: MD
Location Address46 BROOK RDValley Stream, NY 11581-2416
Mailing Address46 Brook RdValley Stream, NY 11581-2416 · (516) 508-0128
Phone(516) 508-0128
Sole ProprietorYes
Medical School CMSOtherGraduated 1987
Enumeration DateJanuary 16, 2008
Last NPPES UpdateMay 20, 2020
NPPES CertifiedMay 20, 2020
✔ NPI 1063698330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatric HospitalHospitals
Taxonomy Code283Q00000X
License✔ Licensed in NY · P60621
Definition
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License ACN1119 (FL)
46 BROOK RD, Valley Stream, NY 11581
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Clifton Rudolph Lake Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759534472
PECOS Enrollment IDI20200207001491
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
66 services29 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
23 services13 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
14 services14 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
12 services11 patients

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 Clifton Lake's NPI number?

The NPI number for Clifton Lake is 1063698330. It was assigned to this individual provider in the NPPES registry on January 16, 2008.

Where is Clifton Lake located?

Clifton Lake practices at 46 Brook Rd, Valley Stream, NY 11581. The listed phone number is (516) 508-0128.

What is Clifton Lake's specialty?

The primary specialty registered for this NPI is Psychiatric Hospital with taxonomy code 283Q00000X.

Is Clifton Lake enrolled in Medicare?

Yes. Clifton Lake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Clifton Lake accept?

Health plans from Ambetter Health and Ambetter of Alabama list Clifton Lake as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Clifton Lake was last updated on May 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.