Active NPI
Lynnet M Bulambo, PMHNP-BC
- Psychiatry Physician
- Roswell, NM
National Provider Identifier
1063891307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 58185
- Practice address
- 613 W 2ND St # 1&3
Roswell, NM 88201-4671 - Phone
- (210) 900-0729
- NPI assigned
- May 20, 2015
- Sex
- Female
- 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 | 58185 | NM | Primary |
Addresses
Primary practice location
613 W 2ND St # 1&3
Roswell, NM 88201-4671
Mailing address
PO Box 8244
Roswell, NM 88202-8244
Phone (575) 755-5555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
313 W Country Club Rd
Suite 9
Roswell, NM 88201-5804
Phone (575) 425-6047
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58185 | NM | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aetna Home Health Service | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Roswell, NM
- NPI 1386283943
-
- Home Health Agency
- San Antonio, TX
- NPI 1285010884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577318400000",
"number": "1063891307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8244",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882028244",
"telephone_number": "575-755-5555",
"fax_number": "575-755-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 W 2ND ST # 1&3",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882014671",
"telephone_number": "210-900-0729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULAMBO",
"first_name": "LYNNET",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-20",
"last_updated": "2019-12-26",
"certification_date": "2019-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NM",
"license": "58185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.