Individual provider Active NPI

Lancer Naghdechi, DO

  • Child & Adolescent Psychiatry Physician
  • New York, NY
National Provider Identifier
1043715485
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
309809 Issued in NY
Practice address
111 E 80TH St Ste 1D
New York, NY 10075
Phone
(646) 363-6303
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MB11122100 NJ
Child & Adolescent Psychiatry Physician 2084P0804X 309809 NY Primary
Psychiatry Physician 2084P0800X 309089 NY
Child & Adolescent Psychiatry Physician 2084P0804X 25MB11122100 NJ

Addresses

Primary practice location

111 E 80TH St Ste 1D
New York, NY 10075

Mailing address

404 E 79TH St Apt 11D
New York, NY 10075-1406
Phone (646) 363-6303

Other practice location 1

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-4450

Other practice location 2

75-59 263rd Street
Glen Oaks, NY 11004
Phone (718) 470-4834

Other practice location 3

300 Arthur Godfrey Rd Ste 213
Miami Beach, FL 33140-3627
Phone (646) 363-6303

Other practice location 4

87 NJ-17 North
ste 118
Maywood, NJ 07607
Phone (551) 996-5729

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
I20230519000954 NJ Practitioner - Psychiatry 7810391364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

150 Overlook Ave
Hackensack, NJ 07601-2206
Phone (201) 489-5999

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11122100NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC Psychiatry CurrentSince May 8, 2023 Accepting new patients
Lancer Health PLLC Child & Adolescent Psychiatry CurrentSince Apr 21, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 8, 2023 Accepting new patients

Locations

300 W 41st St
Ste 213
Miami Beach, FL 33140
Phone (305) 674-1314

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

Interoperability endpoints

  • Direct secure messaging: lancer.naghedchi@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1043715485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 E 79TH ST APT 11D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751406",
            "telephone_number": "646-363-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 80TH ST STE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10075",
            "telephone_number": "646-363-6303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-4450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75-59 263rd Street",
            "address_purpose": "LOCATION",
            "city": "Glen Oaks",
            "state": "NY",
            "postal_code": "11004",
            "country_code": "US",
            "telephone_number": "718-470-4834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Arthur Godfrey Rd Ste 213",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331403627",
            "country_code": "US",
            "telephone_number": "646-363-6303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "87 NJ-17 North",
            "address_2": "ste 118",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "NJ",
            "postal_code": "07607",
            "country_code": "US",
            "telephone_number": "551-996-5729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGHDECHI",
        "first_name": "LANCER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MB11122100",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "309809",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "309089",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MB11122100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.