Individual provider Active NPI

Martin G Lineham, PH.D.

  • Psychologist
  • Rochester, NY
National Provider Identifier
1164505384
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
013237 Issued in NY
Practice address
2257 S Clinton Ave
Rochester, NY 14618-2623
Phone
(585) 442-4010
Fax
(585) 442-4012
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 013237 NY Primary

Addresses

Primary practice location

2257 S Clinton Ave
Rochester, NY 14618-2623

Mailing address

2257 S Clinton Ave
Rochester, NY 14618-2623
Phone (585) 442-4010

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
I20050819000196 NY Practitioner - Clinical Psychologist 1052341963 Practice locations: Rochester, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

980 Westfall Rd
Suite 115
Rochester, NY 14618-2607
Phone (585) 442-4010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013237NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert M. Biernbaum, D.O., P.C. Past Accepting new patients

Organizations & group practices 1

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1164505384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 S CLINTON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182623",
            "telephone_number": "585-442-4010",
            "fax_number": "585-442-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2257 S CLINTON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182623",
            "telephone_number": "585-442-4010",
            "fax_number": "585-442-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINEHAM",
        "first_name": "MARTIN",
        "middle_name": "G",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "013237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.