Dr David Lake Gormsen, DO - Medicare Emergency Medicine in Canton, OH

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Dr David Lake Gormsen, DO is a medicare enrolled "Emergency Medicine - Pediatric Emergency Medicine" physician in Canton, Ohio. His current practice location is 1320 Mercy Dr Nw, Canton, Ohio. You can reach out to his office (for appointments etc.) via phone at (330) 489-1074.

Dr David Lake Gormsen is licensed to practice in Ohio (license number 34002838) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619014602.

Contact Information

Dr David Lake Gormsen, DO
1320 Mercy Dr Nw,
Canton, OH 44708-2614
(330) 489-1074
(330) 489-1487

Map and Direction




Physician's Profile

Full NameDr David Lake Gormsen
GenderMale
SpecialityEmergency Medicine - Pediatric Emergency Medicine
Location1320 Mercy Dr Nw, Canton, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1619014602
  • Provider Enumeration Date: 01/31/2007
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 9436106176
  • Enrollment ID: I20090107000045

Medical Identifiers

Medical identifiers for Dr David Lake Gormsen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619014602NPI-NPPES
34002838OtherOHMEDICAL LICENSE NUMBER

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207PP0204XEmergency Medicine - Pediatric Emergency Medicine 34002838 (Ohio)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr David Lake Gormsen allows following entities to bill medicare on his behalf.
Entity NameCleveland Clinic Mercy Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366433195
PECOS PAC ID: 0547156796
Enrollment ID: O20040224001287

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr David Lake Gormsen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr David Lake Gormsen, DO
4189 Songbird Trl,
Stow, OH 44224-2572

Ph: (330) 688-4160		Dr David Lake Gormsen, DO
1320 Mercy Dr Nw,
Canton, OH 44708-2614

Ph: (330) 489-1074

Reviews and Comments


Emergency Medicine Doctors in Canton, OH

Dr. Douglas Allen Wood, DO
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Phone: 330-456-2695    Fax: 330-363-5380
Monique Cunin, MD, MPH
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Timothy M O'toole, MD
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Phone: 330-363-3926    Fax: 330-363-5380
Dr. Andrew Jacques, MD
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Phone: 330-493-4443    Fax: 330-493-8677
Cody Rider, D.O.
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Phone: 330-363-3926    
Raymond Joseph Biersbach, M.D.
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Practice Location: 4535 Dressler Rd Nw, Canton, OH 44718
Phone: 440-953-9600    
John Velikoff, MD
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Medicare: Medicare Enrolled
Practice Location: 4535 Dressler Rd Nw, Canton, OH 44718
Phone: 330-493-4443    Fax: 330-451-4033

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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