Individual provider Active NPI

Adam M Lynn, PSYD

  • Clinical Psychologist
  • Bronx, NY
National Provider Identifier
1154463263
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014074 Issued in NY
Practice address
1910 Pelham Pkwy S
Apt 1B
Bronx, NY 10461-3726
Phone
(718) 823-4864
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 014074 NY Primary

Addresses

Primary practice location

1910 Pelham Pkwy S
Apt 1B
Bronx, NY 10461-3726

Mailing address

1910 Pelham Pkwy S
Apt 1B
Bronx, NY 10461-3726
Phone (718) 823-4864

Other identifiers 1

IdentifierTypeStateIssuer
02022920MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315000442 NY Practitioner - Clinical Psychologist 6901795160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

250 E Hartsdale Ave
Suite 23
Hartsdale, NY 10530-3574
Phone (646) 456-0205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Psychological PLLC CurrentSince Mar 3, 2005 Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients

Locations

1910 Pelham Pkwy S
Apt 1B
Bronx, NY 10461
Phone (718) 823-4864

2307 Eastchester Rd
Bronx, NY 10469
Phone (646) 456-0205

250 E Hartsdale Ave
Ste 23
Hartsdale, NY 10530
Phone (646) 456-0205

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1154463263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PELHAM PKWY S",
            "address_2": "APT 1B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613726",
            "telephone_number": "718-823-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PELHAM PKWY S",
            "address_2": "APT 1B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613726",
            "telephone_number": "718-823-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "ADAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02022920",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.