CARISSA M LACKEY MD, MPH
NPI 1629642624
Family Medicine in Cambridge, NY

Q: What is Carissa Lackey's NPI number?

The NPI number for Carissa Lackey is 1629642624. It was assigned to this individual provider in the NPPES registry on May 14, 2021.

Q: What is Carissa Lackey's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Carissa Lackey was last updated on September 24, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 14, 2021PECOS EnrolledAccepts Medicare Assignment

35 GILBERT STREET, CAMBRIDGE MEDICAL CENTER, CAMBRIDGE, NY 12816(518) 677-3961(518) 677-3180 Get Directions Write a Review

NPPES record last updated: September 24, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 24, 2024, May 14, 2021 (2 updates tracked since 2021).

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About Carissa M Lackey Md, Mph NPPES

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

CARISSA M LACKEY MD, MPH (NPI 1629642624) is an individual family medicine provider in Cambridge, New York, licensed in New York (332725) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS, is affiliated with Albany Medical Center Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1629642624

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameCARISSA M LACKEYCredential: MD, MPH

Location Address35 GILBERT STREET, CAMBRIDGE MEDICAL CENTERCambridge, NY 12816-2618

Mailing Address100 Park Street, Glens Falls Hospital - CredentialingGlens Falls, NY 12801-4413 · (518) 926-5924 · Fax (518) 926-6983

Phone(518) 677-3961

Fax(518) 677-3180

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateMay 14, 2021

Last NPPES UpdateSeptember 24, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2024

✔ NPI 1629642624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 332725

Definition

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.

35 GILBERT STREET, Cambridge, NY 12816

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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

Carissa M Lackey Md, Mph 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 ID8426599010

PECOS Enrollment IDI20240923003723

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.

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Albany Medical Center Hospital

Acute Care Hospitals · Albany, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330013

Location43 New Scotland Avenue, Mail Code 34Albany, NY 12208 · Albany County

Emergency services Birthing friendly

Glens Falls Hospital

Acute Care Hospitals · Glens Falls, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330191

Location100 Park StreetGlens Falls, NY 12801 · Warren County

Emergency services Birthing friendly

Saratoga Hospital

Acute Care Hospitals · Saratoga Springs, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330222

Location211 Church StreetSaratoga Springs, NY 12866 · Saratoga County

Emergency services Birthing friendly

Southwestern Vermont Medical Center

Acute Care Hospitals · Bennington, VT

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number470012

Location100 Hospital DriveBennington, VT 05201 · Bennington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12816 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

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Other Providers at the Same Location NPPES 9

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

ABIGAIL GRAVES

Nurse Practitioner (Family)