Active NPI
Lourival Baptista Neto, M.D.
- Child & Adolescent Psychiatry Physician
- New York, NY
National Provider Identifier
1194771683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 250963
- Practice address
- 3959 Broadway
619 North
New York, NY 10032-1559 - Phone
- (212) 305-7879
- Fax
- (212) 305-6614
- NPI assigned
- May 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 212802 | MA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 250963 | NY | Primary |
Addresses
Primary practice location
3959 Broadway
619 North
New York, NY 10032-1559
Mailing address
1051 Riverside Dr Ste 6004
New York, NY 10032-1007
Phone (646) 774-5365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212802 | MA | MD | Child & Adolescent Psychiatry Physician |
| 250963 | NY | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colony Care Inc | Past | Accepting new patients |
Interoperability endpoints
- lob9032@direct.nyp.org
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.
-
- Mental Health Counselor
- Wellesley, MA
- NPI 1720053408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524528000000",
"number": "1194771683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1051 RIVERSIDE DR STE 6004",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100321007",
"telephone_number": "646-774-5365",
"fax_number": "646-774-5359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3959 BROADWAY",
"address_2": "619 NORTH",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100321559",
"telephone_number": "212-305-7879",
"fax_number": "212-305-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAPTISTA NETO",
"first_name": "LOURIVAL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2018-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "212802",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "250963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.