Carissa A Webster-Lake, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

59921 Issued in TN

Practice address

2550 Albany Ave # 1056
West Hartford, CT 06117-2335

Phone

(617) 869-0135

NPI assigned

May 28, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, MA, VA, PA4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Vascular Surgery

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health of New England Provider Network Organization IncGroup PAC ID 0941113567, 644 clinicians

St Joseph Medical GroupGroup PAC ID 3779688650, 190 clinicians

Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096
• Danbury Hospital Hospital, Danbury, CT, CCN 070033
• Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066
• St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwebsterlake2386817@direct.trinity-health.org
• Direct secure messaging: cwebsterlake244161@direct.rivhs.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment Care Compare group NPD
• Riverbend Medical Group, Inc.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1841651197

  Surgery

  Medicare reassignment Care Compare group NPD
• St. Joseph Medical Group

  • Family Medicine Physician
  • Reading, PA
  • NPI 1184754657

  Surgery

  Medicare reassignment Care Compare group NPD
• Nuvance Health Medical Practice CT, Inc.

  • Internal Medicine Physician
  • Danbury, CT
  • NPI 1407898117
  Medicare reassignment Care Compare group
• Bristol Hospital Multi Specialty Group, Inc

  • General Practice Physician
  • Bristol, CT
  • NPI 1649265679

  Surgery

  Medicare reassignment NPD
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment NPD
• Hartford Healthcare Medical Group, Inc

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301
  Medicare reassignment NPD
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Riverbend Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1265023154
  NPD
• St. Joseph Medical Group

  • Anesthesiology Physician
  • Reading, PA
  • NPI 1841680881
  NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Danbury Hospital

  • Dental Clinic/Center
  • Danbury, CT
  • NPI 1003835935

  Hospital

  Care Compare affiliation
• Danbury Hospital

  • General Acute Care Hospital
  • Danbury, CT
  • NPI 1548293343
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • Psychiatric Hospital Unit
  • Hartford, CT
  • NPI 1144234428
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1407833486
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1871713495
  Care Compare affiliation
• St Joseph Regional Health Network

  • General Acute Care Hospital
  • Reading, PA
  • NPI 1699734665
  Care Compare affiliation
• The Mercy Hospital Inc

  • General Acute Care Hospital
  • Springfield, MA
  • NPI 1043204316
  Care Compare affiliation
• The Mercy Hospital Inc

  • Rehabilitation Hospital Unit
  • Springfield, MA
  • NPI 1750360798
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1134448269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 ALBANY AVE # 1056",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172335",
            "fax_number": "901-271-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 ALBANY AVE # 1056",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172335",
            "telephone_number": "617-869-0135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 J Clyde Morris Blvd # 603",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011929",
            "country_code": "US",
            "telephone_number": "757-534-5340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBSTER-LAKE",
        "first_name": "CARISSA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "54698",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CT",
            "license": "54698",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101279557",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "59921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy N Watkins, MSW,BA,LMSW, LCSW
• Latoya Cynthia Watson
• Hannah Waxler, RDN
• Linda Chase Wayman, LINDA WAYMAN, LPC
• Benjamin J Weber, D.M.D.
• Wehamh PC
• Michelle L Weinberg, LMFT
• Daniel Weiner, MA
• Arnold Edward Weinstein, DMD
• Robert James Weinstein, PH.D.

• Vascular Surgery Physician in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Vascular Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.