Individual provider Active NPI

William Drake III, M.D.

  • Otolaryngology Physician
  • Mountainside, NJ
National Provider Identifier
1861489890
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MA060639 Issued in NJ
Practice address
213 Summit Rd
Suite 1
Mountainside, NJ 07092-2316
Phone
(908) 233-2111
Fax
(908) 458-9944
NPI assigned
Oct 4, 2005
Last updated
Jan 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MA060639 NJ Primary

Addresses

Primary practice location

213 Summit Rd
Suite 1
Mountainside, NJ 07092-2316

Mailing address

213 Summit Rd
Suite 1
Mountainside, NJ 07092-2316
Phone (908) 233-2111

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110318000525 NJ Practitioner - Otolaryngology 0749181394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Rutgers New Jersey Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drake and Presti ENT Surgical Associates, LLCGroup PAC ID 2062684541, 2 clinicians

Practice addresses (Care Compare)

213 Summit Rd
Mountainside, NJ 07092-2316
Phone (908) 233-2111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA060639NJMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Drake & Presti ENT Surgical Associates, LLC Otolaryngology CurrentSince Jun 1, 2011 Accepting new patients

Locations

213 Summit Rd
Mountainside, NJ 07092
Phone (908) 233-2111

213 Summit Rd
Ste 1
Mountainside, NJ 07092
Phone (908) 233-2111

189 Elm St
Westfield, NJ 07090
Phone (908) 233-5500

Organizations & group practices 1

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1861489890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 SUMMIT RD",
            "address_2": "SUITE 1",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922316",
            "telephone_number": "908-233-2111",
            "fax_number": "908-458-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 SUMMIT RD",
            "address_2": "SUITE 1",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922316",
            "telephone_number": "908-233-2111",
            "fax_number": "908-458-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE III",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "MA060639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

Verify at the official NPI Registry.