NPIMap

Organization Active NPI

Wingspan Psychiatric, LLC

  • Psychiatry Physician
  • Mount Vernon, NY
National Provider Identifier
1093088502
Registry record updated Dec 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
189845 Issued in NY
Legal business name
WINGSPAN PSYCHIATRIC, LLC
Practice address
138 S Columbus Ave FL 1
Mount Vernon, NY 10553-1337
Phone
(914) 413-1553
Fax
(978) 701-6001
NPI assigned
Feb 14, 2012
Last updated
Dec 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
WINGSPAN PSYCHIATRIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 27, 2020

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

Authorized official

Name
Francis Hayden II, MDNPI 1346334653
Title
Owner
Phone
(914) 413-1553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 189845 NY Primary

Addresses

Primary practice location

138 S Columbus Ave FL 1
Mount Vernon, NY 10553-1337

Mailing address

101 Ellwood Ave Apt 4a
Mount Vernon, NY 10552-3428
Phone (914) 413-1553

Other identifiers 2

IdentifierTypeStateIssuer
03438319MedicaidNY
01550791MedicaidNY

Other names 1

  • Francis Hayden, M.D. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Wingspan Psychiatric LLC2 organizations share this tax ID, including this one
Part of
Wingspan Psychiatric LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609027200000",
    "number": "1093088502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ELLWOOD AVE APT 4A",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523428",
            "telephone_number": "914-413-1553",
            "fax_number": "917-791-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S COLUMBUS AVE FL 1",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531337",
            "telephone_number": "914-413-1553",
            "fax_number": "978-701-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGSPAN PSYCHIATRIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINGSPAN PSYCHIATRIC LLC",
        "enumeration_date": "2012-02-14",
        "last_updated": "2020-12-27",
        "certification_date": "2020-12-27",
        "status": "A",
        "authorized_official_last_name": "HAYDEN",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-413-1553",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "189845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03438319",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01550791",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Francis Hayden, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Francis Hayden, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.