Active NPI
Jilynn Eagen, PH.D.
- Psychologist
- West Seneca, NY
National Provider Identifier
1063914687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 023061
- Practice address
- 1010 E and West Rd
West Seneca, NY 14224-3698 - Phone
- (716) 677-7000
- NPI assigned
- Feb 28, 2018
- Last updated
- Aug 27, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 023061 | NY | Primary |
| School Psychologist | 103TS0200X | 0813000934 | VA |
Addresses
Primary practice location
1010 E and West Rd
West Seneca, NY 14224-3698
Mailing address
1010 E and West Rd
West Seneca, NY 14224-3698
Phone (716) 677-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0813000934 | VA | MD | School Psychologist |
| 023061 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566864000000",
"number": "1063914687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 E AND WEST RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142243698",
"telephone_number": "716-677-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 E AND WEST RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142243698",
"telephone_number": "716-677-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGEN",
"first_name": "JILYNN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-28",
"last_updated": "2019-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "023061",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "VA",
"license": "0813000934",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Seneca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.