Evan B. Drake, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

003265 Issued in CT

Practice address

28 Thorndal Cir Ste 3
Darien, CT 06820-5429

Phone

(203) 309-2707

Fax

(877) 951-2288

NPI assigned

Nov 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Gaylord Hospital, Inc.

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Neurology Physician
  • New York, NY
  • NPI 1306899455
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1336214477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 NICKERSON LN",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068205720",
            "telephone_number": "203-309-2707",
            "fax_number": "877-951-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 THORNDAL CIR STE 3",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068205429",
            "telephone_number": "203-309-2707",
            "fax_number": "877-951-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "EVAN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "003265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008053170",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Dobey, PHD
• Jake Dolson, DPT
• James Richard Dorr, M.D.
• Mary Gerard Doucet, LCSW
• Lanae R Drachslin
• Brenna Maeve Driscoll, OTR/L
• DSN Eyecare, LLC
• John Matthew Dubaz, M.D.
• Alyssa Paige Dudzik
• Stephen N. Dulski

• Clinical Neuropsychologist in Darien, CT
• Providers in Darien, CT by specialty
• Clinical Neuropsychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.