Niles Drake, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

252882 Issued in NY

Practice address

333 W 57TH St
Suite 102
New York, NY 10019-3159

Phone

(646) 820-9170

Fax

(646) 360-1997

NPI assigned

Jun 10, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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 1

Specialty

Psychiatry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD New Jersey Psychiatry Services LLCGroup PAC ID 8921452350, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• MCCD New Jersey Psychiatry Services LLC

  • Psychiatry Physician
  • Hampton, NJ
  • NPI 1023729530
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1194985507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 57TH ST",
            "address_2": "APT 3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193159",
            "telephone_number": "713-456-9039",
            "fax_number": "646-360-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W 57TH ST",
            "address_2": "SUITE 102",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193159",
            "telephone_number": "646-820-9170",
            "fax_number": "646-360-1997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 W 27th St Ste 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100010265",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Route 73 N Ste 117",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080533422",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "NILES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "252882",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA09552700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles George Drake, M.D.
• Christin Drake, M.D.
• Jamielynn Cormack Drake, NP
• Julie Drake, CNM
• Lauren Drake
• Stacie C Drake, PMHNP-BC
• Victoria D Drake, ANP
• Amy E Drakeman, LCSW
• Vonetta Andrea Drakes, D.O.
• Mark C. Drakos, M.D.

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.