Active NPI
Robert Eric Stake, MD
- Psychiatry Physician
- Haverford, PA
National Provider Identifier
1699841551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD020855E
- Practice address
- 385 West Lancaster Avenue
Suite 207
Haverford, PA 19041-1551 - Phone
- (610) 645-0976
- NPI assigned
- Nov 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD020855E | PA | Primary |
Addresses
Primary practice location
385 West Lancaster Avenue
Suite 207
Haverford, PA 19041-1551
Mailing address
385 West Lancaster Avenue
Suite 207
Haverford, PA 19041-1551
Phone (610) 645-0976
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 18, 2017 through Jan 18, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD020855E | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699841551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 WEST LANCASTER AVENUE",
"address_2": "SUITE 207",
"city": "HAVERFORD",
"state": "PA",
"postal_code": "190411551",
"telephone_number": "610-645-0976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 WEST LANCASTER AVENUE",
"address_2": "SUITE 207",
"city": "HAVERFORD",
"state": "PA",
"postal_code": "190411551",
"telephone_number": "610-645-0976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAKE",
"first_name": "ROBERT",
"middle_name": "ERIC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD020855E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haverford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.