CARISSA A WEBSTER-LAKE (MD) – Vascular Surgery Physician, NPI 1134448269
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
120 VASCULAR SURGERY in CT
Provider Addresses for CARISSA A WEBSTER-LAKE (MD)
2550 ALBANY AVE # 1056
WEST HARTFORD, CT 061172335
Phone:
Fax: (901) 271-0155
Type: Mailing
PO BOX 1000, DEPT 457
MEMPHIS, TN 381480001
Phone: (901) 275-3662
Fax: (901) 271-0155
Type: Mailing
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 381047544
Phone: (901) 272-6010
Fax: (901) 266-6468
Type: Location
500 J Clyde Morris Blvd # 603
Newport News, VA 236011929
Phone: (757) 534-5340
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $1,548.
Total Amount is formed as General ($1,548) + Research ($0) + Ownership ($0) = $1,548.
Last reported payment date: 2024-03-28 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($1,483).
Total Amount
$1,548
General + Research + Ownership
Payments
9
Total payment records
General Amount
$1,548
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $1,483 |
| Endologix LLC | $38 |
| Smith+Nephew, Inc. | $27 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-10-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170614000363 | I | Vascular Surgery | CT | TBD |
| I20230515000942 | I | Vascular Surgery | MA | TBD |
| I20230926003902 | I | Vascular Surgery | VA | TBD |
| I20251029002107 | I | Vascular Surgery | PA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 24 | 22 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 21 | 21 | $0 |
Insurance plans in this area (ZIP 06117)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CT | |
| - | CT | |
| - | WA | |
| A N E S T H E S I O L O G Y | GA | |
| Certified Registered Nurse Anesthetist (Crna) | CT | |
| - | NY | |
| General Surgery | CT | |
| - | CT | |
| - | CT | |
| - | GA |
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