Active NPI
Martin Joseph Lyden, PH.D.
- Psychologist
- Troy, NY
National Provider Identifier
1215926456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 006029
- Practice address
- 267 Hoosick St
Troy, NY 12180-2467 - Phone
- (518) 271-6949
- Fax
- (518) 449-7965
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 006029 | NY | Primary |
Addresses
Primary practice location
267 Hoosick St
Troy, NY 12180-2467
Mailing address
1807 9TH St
Rensselaer, NY 12144-1420
Phone (518) 271-6949
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00568790 | Medicaid | NY | |
| 6111201 | Other | NY | UNITED BEHAVIORAL HEALTH |
| 141721313 | Other | NY | VALUEOPTIONS |
| 41171 | Other | NY | MVP |
| 000490239002 | Other | NY | BLUE SHIELD OF NENY |
| 58184 | Other | NY | CIGNA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111017000507 | NY | Practitioner - Clinical Psychologist | 3870765829 | Practice locations: Rensselaer, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286496000000",
"number": "1215926456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1807 9TH ST",
"city": "RENSSELAER",
"state": "NY",
"postal_code": "121441420",
"telephone_number": "518-271-6949",
"fax_number": "518-449-7965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 HOOSICK ST",
"city": "TROY",
"state": "NY",
"postal_code": "121802467",
"telephone_number": "518-271-6949",
"fax_number": "518-449-7965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYDEN",
"first_name": "MARTIN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2010-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "006029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00568790",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "6111201",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "141721313",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "41171",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF NENY",
"identifier": "000490239002",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "58184",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.