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DR. CARL THOMAS DRAKE D.D.S., M.S.
NPI 1124227228
Dentist in Normal, IL

Active since July 17, 2007Opted out of Medicare · through May 17, 2028
310 SUSAN DR, STE 1, NORMAL, IL 61761(309) 808-0054 Get Directions Write a Review

NPPES record last updated: May 27, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Carl Thomas Drake D.d.s., M.s. NPPES

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

DR. CARL THOMAS DRAKE D.D.S., M.S. (NPI 1124227228) is an individual dentist in Normal, Illinois, licensed in Illinois (019.027428) and active in the NPI registry since July 2007. He has opted out of Medicare through May 17, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1124227228
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. CARL THOMAS DRAKECredential: D.D.S., M.S.
Location Address310 SUSAN DR, STE 1Normal, IL 61761-6206
Mailing Address310 Susan Drive, Suite 1Normal, IL 61761 · (309) 808-0054
Phone(309) 808-0054
Sole ProprietorNo
Enumeration DateJuly 17, 2007
Last NPPES UpdateMay 27, 2011
✔ NPI 1124227228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019.027428
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedDentist · Orthodontics and Dentofacial OrthopedicsTaxonomy 1223X0400X · License 021.002368 (IL)
310 SUSAN DR, Normal, IL 61761
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Carl Thomas Drake D.d.s., M.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 17, 2016 through May 17, 2028.

Opt-Out Effective DateMay 17, 2016
Opt-Out In Effect ThroughMay 17, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61761 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
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

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

JOHNSON CHIROPRACTIC, SC
Clinic/Center
310 SUSAN DR, SUITE 2
NORMAL, IL 61761
McLean County (309) 808-1123

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 Carl Drake's NPI number?

The NPI number for Carl Drake is 1124227228. It was assigned to this individual provider in the NPPES registry on July 17, 2007.

Where is Carl Drake located?

Carl Drake practices at 310 Susan Dr Ste 1, Normal, IL 61761. The listed phone number is (309) 808-0054.

What is Carl Drake's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Carl Drake enrolled in Medicare?

No. Carl Drake has opted out of Medicare through May 17, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Carl Drake was last updated on May 27, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.